Individual
CARISSA COWLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 2ND AVE S, FARGO, ND 58103-8226
(701) 234-4596
Mailing address
1010 2ND AVE S, FARGO, ND 58103-8226
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3585
ND
Other
Enumeration date
04/17/2014
Last updated
04/17/2014
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