Individual
HEATHER RENEE IBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC, LSW
Contact information
Practice address
1237 W DIVIDE AVE, STE 5, BISMARCK, ND 58501-1208
(701) 328-8888
(701) 328-8900
Mailing address
1237 W DIVIDE AVE, STE 5, BISMARCK, ND 58501-1208
(701) 328-8888
(701) 328-8900
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1622
ND
104100000X
Social Worker
4272
ND
Other
Enumeration date
04/15/2010
Last updated
07/09/2012
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