Individual
ALYSSA WENNERBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
819 30TH AVE S STE 103D, MOORHEAD, MN 56560-5000
(701) 428-2327
Mailing address
819 30TH AVE S STE 103D, MOORHEAD, MN 56560-5000
(701) 428-2327
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
912-8-1-17-360
ND
101YP2500X
Professional Counselor
912-8-1-17A
ND
Other
Enumeration date
08/29/2017
Last updated
11/26/2024
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