Axtman, Mystal Rae

Axtman, Mystal Rae is an sole proprietor health care provider with primary practice located at 4675 40Th Ave S Ste 115 , Fargo ND 58104-4592. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Axtman, Mystal Rae can be contacted via phone (701) 478-0906.

Contact Information

Primary practice address
4675 40Th Ave S Ste 115 Fargo ND 58104-4592
Phone: (701) 478-0906
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 472-3-1-02-164 North Dakota
Behavioral Health & Social Service Providers / Professional 101YP2500X 472-3-1-02-164 North Dakota

Profile Details

NPI number 1285775569
LBN Legal business name Axtman, Mystal Rae
Credentials M.S., LPCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 9th, 2007
Last updated Feb 15th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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