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General NPI Number Information
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NPI Number | 1689600868
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Entity Type | Individual
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Provider Name | ALLEN L SIEGLER JR. LICSW, BCD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 300 13TH AVE W SUITE 1
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City | DICKINSON
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State | ND
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Zip | 58601-4879
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Country | US
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Telephone | 701-227-7533
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Fax | 701-227-7575
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Provider Business Mailing Address
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Address Line | 300 13TH AVE W SUITE 1
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City | DICKINSON
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State | ND
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Zip | 58601-4879
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Country | US
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Telephone | 701-227-7533
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Fax | 701-227-7575
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1280
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License Number State | ND
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