Corneliussen, Stephanie J

Corneliussen, Stephanie J is an individual health care provider with primary practice located at 100 4Th St S , Fargo ND 58103-1929. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Corneliussen, Stephanie J can be contacted via phone (701) 234-3100.

Contact Information

Primary practice address
100 4Th St S Fargo ND 58103-1929
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X

Profile Details

NPI number 1255605762
LBN Legal business name Corneliussen, Stephanie J
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2012
Last updated Jul 26th, 2012 - about 13 years ago

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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Identifiers

StateTypeNumberIssuer
All States NPI 1255605762 NPPES
North Dakota MEDICAID 16885

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