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Jason C Fahlstrom
Peer Specialist in Washburn, North Dakota
NPI 1144086117

Jason C Fahlstrom is a Peer Specialist based in Washburn, ND. Jason C Fahlstrom practices in Washburn, ND. The NPI Number for Jason C Fahlstrom is 1144086117 and holds a License No. (North Dakota).

The current practice location address for Jason C Fahlstrom is 927 Main Ave, Washburn, ND and can be reached out via phone at 701-301-7635.

Location: 927 Main Ave, Washburn, ND, 58577-4221
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144086117
Provider Name
Jason C Fahlstrom
Credential
Provider Entity Type
Individual
Gender
Male
Address
927 Main Ave, Washburn, ND, 58577-4221
Phone Number
701-301-7635
Fax Number
Provider Enumeration Date
02/26/2024
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
927 Main Ave
City
Washburn
State
North Dakota
Zip
58577-4221
Phone Number
701-301-7635
Fax Number
person
Provider Business Mailing Address Details
Address
927 Main Ave
City
Washburn
State
North Dakota
Zip
58577-4221
Phone Number
701-301-7635
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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