Healthcare Provider Details

I. General information

NPI: 1477256287
Provider Name (Legal Business Name): PRESLEY MORSTAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 2ND AVE NW
WEST FARGO ND
58078-1161
US

IV. Provider business mailing address

1547 30TH AVE S
MOORHEAD MN
56560-5149
US

V. Phone/Fax

Practice location:
  • Phone: 701-412-2973
  • Fax:
Mailing address:
  • Phone: 218-287-4338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1271-3-15-23A
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: