| Impact Therapy, Pllc | |
|
3426 Bay Shore Bnd Se Mandan ND 58554-6259 | |
| (701) 516-6980 | |
| Not Available |
| Full Name | Impact Therapy, Pllc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 3426 Bay Shore Bnd Se, Mandan, North Dakota |
| Authorized Official Name and Position | Heather Moser (OWNER) |
| Authorized Official Contact | 7015166980 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Therapy, Pllc 3426 Bay Shore Bnd Se Mandan ND 58554-6259 Ph: (701) 516-6980 | Impact Therapy, Pllc 3426 Bay Shore Bnd Se Mandan ND 58554-6259 Ph: (701) 516-6980 |
| NPI Number | 1619763299 |
|---|---|
| Provider Enumeration Date | 04/18/2025 |
| Last Update Date | 04/18/2025 |
| Certification Date | 04/18/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619763299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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