Doctor Name: | ALICIA M SCHROEDER |
NPI Number: | 1154593507 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LAC, LADC |
License Number: | 1569 |
Business Practice Address: | 715 11th St N Ste 204 Moorhead, MN - 565602000 |
Business Phone Number: | 2182336398 |
Business Fax Number: | 2182366765 |
Mailing Address: | 4227 9th Ave Sw, FARGO |
State: | ND |
Postal Code: | 581032018 |
Phone Number: | 7012826561 |
Fax Number: | 7012770306 |
NPI Enumeration Date: | 03/26/2008 |
NPI Last Update Date: | 03/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1569 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ND |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |