Tamrin Brenno-Fagerland, LSW

Individual provider Active NPI Social Worker · Williston, ND

NPI 1710063284 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1710063284
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
2829 (ND)
Practice address
316 2ND Ave W
Williston, ND 58801-5218
Phone
(701) 774-4600
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2829NDMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2829 ND Yes

Addresses

Primary practice location

316 2ND Ave W
Williston, ND 58801-5218

Mailing address

PO Box 1266
Williston, ND 58802-1266

Other identifiers

IdentifierTypeStateIssuer
54516MedicaidND

Other names

  • Tamrin Brenno Former name

Other providers in Williston, ND

All providers in Williston, ND · Social Worker in North Dakota

Sources for this page

Verify at the official NPI Registry.