Healthcare Provider Details

I. General information

NPI: 1255088878
Provider Name (Legal Business Name): RACHEL ANN ATKINS LBSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 7TH AVE E
WILLISTON ND
58801-4450
US

IV. Provider business mailing address

1113 6TH AVE E APT 2
WILLISTON ND
58801-4446
US

V. Phone/Fax

Practice location:
  • Phone: 701-572-7262
  • Fax:
Mailing address:
  • Phone: 281-622-0046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6172
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: