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Individual

NATE SCOTT BIVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
701 3RD ST NW, JAMESTOWN, ND 58401-2963
(701) 252-3850
Mailing address
701 3RD ST NW, JAMESTOWN, ND 58401-2963

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-42248
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
RBT-17-42248
ND
Enumeration date
11/14/2017
Last updated
11/14/2017
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