Most Relevant Information
Provider Data
| NPI Number: | 1003359779 |
| Provider Name: | MICHELLE NIEMISTE |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 5359 |
Most Important Dates
| Enumeration Date: | 11/29/2016 |
| Last Updated: | 03/11/2020 |
Provider Practice Location
1202 WESTRAC DR S
FARGO
ND
581032338
Practice Location Phone/Fax
| Phone: | 7012809545 |
| Fax: |
Provider Mailing Location
1202 WESTRAC DR S
FARGO
ND
581032338
Provider Mailing Phone/Fax
| Phone: | 7012809545 |
| Fax: |