Individual
ALISSA L DECOTEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
(701) 364-8906
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
25665
MN
1041C0700X
Clinical Social Worker
Primary
4245
ND
Other
Enumeration date
04/04/2011
Last updated
10/16/2019
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