Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 1624 | ND |
N | 104100000X | Social Worker | 3661 | ND |
NPI | 1003271008 |
---|---|
Provider Name | Dana Maas |
First Address | Hazen, ND 58545-0031 |
Second Address | Beulah, ND 58523-6038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2015 |
Last Update Date | 06/05/2020 |