Basic Information
| Provider Information | |||||||||
| NPI: | 1912579806 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICE | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | MARGARET | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | MASTER OF PSYCHOLOGY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2605 CIRCLE DR | ||||||||
| Address2: | |||||||||
| City: | JAMESTOWN | ||||||||
| State: | ND | ||||||||
| PostalCode: | 584016905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7012533650 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2605 CIRCLE DR | ||||||||
| Address2: | |||||||||
| City: | JAMESTOWN | ||||||||
| State: | ND | ||||||||
| PostalCode: | 584016905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7012533650 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2021 | ||||||||
| LastUpdateDate: | 07/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | ND | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 247200000X | Y | Technologists, Technicians & Other Technical Service Providers | Technician, Other |
No ID Information.