Lifesource of North Carolina
NPI #1174168496 in Minot, North Dakota
Provider Information
- NPI Number
- 1174168496
- Entity Type
- Organization
- Organization Name
- Lifesource of North Carolina
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Nov 11, 2019
- Last Updated
- Mar 25, 2021
Practice Location
- Address
- 600 MAIN ST S
- City
- Minot
- State
- North Dakota
- ZIP Code
- 58701-4499
- Phone
- (910) 742-9243
Authorized Official
- Name
- PEGGY BADDOUR
- Title
- PRESIDENT
- Phone
- (910) 338-2882
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
| Psychiatry & Neurology - Psychiatry — Psychiatry |
| Physician Assistant |
| Nurse Practitioner |
| Social Worker - Clinical — Clinical |
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