Individual
DR. COURTNEY GRACE STUFFLEBEAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
Mailing address
1151 32ND AVE N APT 522, FARGO, ND 58102-1251
(701) 330-0375
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
091012
IA
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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