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General NPI Number Information
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NPI Number | 1811726946
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Entity Type | Individual
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Provider Name | REBECCA O PALOMAR
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Gender | Female
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Dates
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Enumeration Date | 07/29/2024
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 3674 S WASHINGTON ST
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City | GRAND FORKS
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State | ND
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Zip | 58201-8155
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Country | US
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Telephone | 701-205-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5210
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City | GRAND FORKS
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State | ND
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Zip | 58206-5210
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 109732
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 109732
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License Number State | TX
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