Heather Ellen Guttormson, MS, LMFT

Individual provider Active NPI Marriage & Family Therapist · Fargo, ND

NPI 1942563705 · NPPES record last updated Jun 18, 2012

Key facts

NPI
1942563705
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
200930 (ND)
Practice address
2624 9TH Ave S
Fargo, ND 58103-2350
Phone
(701) 298-4500
Fax
(701) 298-4400
NPI assigned
Jun 18, 2012
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
200930NDMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 200930 ND Yes

Addresses

Primary practice location

2624 9TH Ave S
Fargo, ND 58103-2350

Mailing address

2624 9TH Ave S
Fargo, ND 58103-2350
Phone (701) 298-4500

Other providers in Fargo, ND

All providers in Fargo, ND · Marriage & Family Therapist in North Dakota

Sources for this page

Verify at the official NPI Registry.