Doctor Name: | MR. CURTIS SCANSON |
NPI Number: | 1689080608 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LADC |
License Number: | 303391 |
Business Practice Address: | 1111 Gateway Dr Ne East Grand Forks, MN - 567212620 |
Business Phone Number: | 2187930420 |
Business Fax Number: | 2187930424 |
Mailing Address: | 1111 Gateway Dr Ne, EAST GRAND FORKS |
State: | MN |
Postal Code: | 567212620 |
Phone Number: | 2187930420 |
Fax Number: | 2187930424 |
NPI Enumeration Date: | 07/10/2014 |
NPI Last Update Date: | 07/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 303391 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |