Most Relevant Information
Provider Data
| NPI Number: | 1003420175 |
| Provider Name: | ALEXIS BERG |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/04/2020 |
| Last Updated: | 06/01/2021 |
Provider Practice Location
4725 AMBER VALLEY PKWY S STE B
FARGO
ND
581048614
Practice Location Phone/Fax
| Phone: | 7014780221 |
| Fax: |
Provider Mailing Location
4725 AMBER VALLEY PKWY S STE B
FARGO
ND
581048614
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |