Healthcare Provider Details

I. General information

NPI: 1821761818
Provider Name (Legal Business Name): ALTHOFF THERAPY SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 OAK RIDGE WAY E
WEST FARGO ND
58078-8481
US

IV. Provider business mailing address

509 OAK RIDGE WAY E
WEST FARGO ND
58078-8481
US

V. Phone/Fax

Practice location:
  • Phone: 701-318-4321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: EMILY ALTHOFF
Title or Position: OWNER
Credential:
Phone: 701-318-4321