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General NPI Number Information
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NPI Number | 1487347902
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Entity Type | Individual
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Provider Name | BROOKE ANN RAYFIELD LAC
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Gender | Female
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Dates
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Enumeration Date | 05/31/2023
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 30 7TH ST W FL 4
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City | DICKINSON
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State | ND
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Zip | 58601-4335
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Country | US
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Telephone | 701-222-0386
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Fax |
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Provider Business Mailing Address
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Address Line | 830 22ND ST W
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City | DICKINSON
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State | ND
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Zip | 58601-2719
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Country | US
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Telephone | 507-313-0562
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 306232
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1999
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License Number State | ND
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