Individual
JODI LYNN DUTTENHEFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
418 E BROADWAY AVE, SUITE 25, BISMARCK, ND 58501-4086
(701) 224-9611
(701) 224-9747
Mailing address
418 E BROADWAY AVE, SUITE 25, BISMARCK, ND 58501-4086
(701) 224-9611
(701) 224-9747
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4537
ND
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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