Doctor Name: | JILL CALDERSON |
NPI Number: | 1669716445 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 738-11-1-12A |
Business Practice Address: | 1726 S Washington St Ste 33a Grand Forks, ND - 582016395 |
Business Phone Number: | 7014514900 |
Business Fax Number: | |
Mailing Address: | 1726 S Washington St Ste 33a, GRAND FORKS |
State: | ND |
Postal Code: | 582016395 |
Phone Number: | 7014514900 |
Fax Number: | |
NPI Enumeration Date: | 11/19/2012 |
NPI Last Update Date: | 11/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 738-11-1-12A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |