Most Relevant Information
Provider Data
| NPI Number: | 1003370149 |
| Provider Name: | BECKA ANNE KOLL LSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 5103 |
Most Important Dates
| Enumeration Date: | 01/23/2019 |
| Last Updated: | 01/23/2019 |
Provider Practice Location
200 2ND AVE NW
MANDAN
ND
585543124
Practice Location Phone/Fax
| Phone: | 7016673281 |
| Fax: |
Provider Mailing Location
200 2ND AVE NW
MANDAN
ND
585543124
Provider Mailing Phone/Fax
| Phone: | 7016673281 |
| Fax: |