Basic Information
| Provider Information | |||||||||
| NPI: | 1578971941 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHANDER | ||||||||
| FirstName: | TRISTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1237 W DIVIDE AVE | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | BISMARCK | ||||||||
| State: | ND | ||||||||
| PostalCode: | 585011220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7013288888 | ||||||||
| FaxNumber: | 7013288900 | ||||||||
| Practice Location | |||||||||
| Address1: | 1237 W DIVIDE AVE | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | BISMARCK | ||||||||
| State: | ND | ||||||||
| PostalCode: | 585011220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7013288888 | ||||||||
| FaxNumber: | 7013288900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2014 | ||||||||
| LastUpdateDate: | 07/31/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 794-7-15-14A | ND | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.