Individual
MS. CHERYL R THIESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
6301 19TH AVE NW, MINOT, ND 58703
(701) 858-0115
Mailing address
PO BOX 5007, MINOT, ND 58702-5007
(701) 858-0115
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1551
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74032
—
ND
Enumeration date
10/12/2006
Last updated
07/08/2007
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