Provider Information for 1073047395
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Ms. CARLYSS ANN KURTTI LPCC
Other Names:Former Name:Ms. CARLYSS ANN NEUFELD LPCC, NCCSex: Female
NPI: 1073047395
Last Updated: 2021-06-03
Certification Date: 2021-06-03
Certification Date: 2021-06-03
Details
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| NPI | 1073047395 | ||||||||||||||||||||||||||||
| Enumeration Date | 2017-04-13 | ||||||||||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||||||||||||||
| Status | Active | ||||||||||||||||||||||||||||
| Mailing Address | 151 S 4TH ST GRAND FORKS, ND 58201-4715 United States Phone: | Fax: | ||||||||||||||||||||||||||||
| Primary Practice Address | 151 S 4TH ST GRAND FORKS, ND 58201-4715 United States Phone: 701-235-4457 | Fax: | ||||||||||||||||||||||||||||
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