Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 522-2-1-05 | ND |
Y | 101YP2500X | Professional Counselor | 522-2-1-05-198 | ND |
NPI | 1003146861 |
---|---|
Provider Name | Rachel A Blumhardt |
First Address | Fargo, ND 58103-2311 |
Second Address | Fargo, ND 58103-8753 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2009 |
Last Update Date | 17/02/2020 |