NPI 1104467174
Fallon Kirby Leiseth
Practice location
- Address
- 12 1st Ave NW, Williston, ND 58801
- Phone
- (701) 609-5376
- Mailing address
- 12 1st Ave W, Williston, ND 58801-6048
Registered specialties
Mental Health Counselor
Primary
Registry record
- NPI
- 1104467174
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 1 Oct 2019
- Record last updated
- 12 Nov 2024
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.