Healthcare Provider Details

I. General information

NPI: 1306732045
Provider Name (Legal Business Name): CORINA ELIZABETH HUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 E BROADWAY AVE STE 7
BISMARCK ND
58501-4086
US

IV. Provider business mailing address

418 E BROADWAY AVE STE 7
BISMARCK ND
58501-4086
US

V. Phone/Fax

Practice location:
  • Phone: 701-380-5100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1454-6-15-25A
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: