NPI 1073158408

Jack K Hartley

Practitioner Addiction (Substance Use Disorder) Counselor Jamestown, ND

Practice location

Address: 520 3rd St NW, Jamestown, ND 58401-2968
Phone: (701) 253-6300

Registered specialties

Addiction (Substance Use Disorder) Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YA0400X Licence 1034-10-1-19A (ND)

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Registry record

NPI: 1073158408
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Nov 2019
Record last updated: 8 Nov 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.