Individual
MINDY MANOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
510 4TH ST S, FARGO, ND 58103-1914
(701) 476-7200
(701) 476-7261
Mailing address
510 4TH ST S, FARGO, ND 58103-1914
(701) 476-7200
(701) 476-7261
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1563
ND
Other
Enumeration date
12/11/2007
Last updated
12/11/2007
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