| Doctor Name: | KERSTE DECOTEAU |
| NPI Number: | 1104227644 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 778-3-15-14A |
| Business Practice Address: | 224 4th St Nw Ste 5 Devils Lake, ND - 583012960 |
| Business Phone Number: | 7016626776 |
| Business Fax Number: | |
| Mailing Address: | 1201 25th St S, Po Box 9859 FARGO |
| State: | ND |
| Postal Code: | 581032311 |
| Phone Number: | 7014514900 |
| Fax Number: | 7014514891 |
| NPI Enumeration Date: | 09/15/2014 |
| NPI Last Update Date: | 09/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 778-3-15-14A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |