Individual
CHEYENNE L HAGENBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1463 I94 BUSINESS LOOP E, DICKINSON, ND 58601-6434
(701) 227-7506
Mailing address
1463 I94 BUSINESS LOOP E, DICKINSON, ND 58601-6434
(701) 227-7506
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
11/28/2022
Last updated
03/27/2023
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