Individual provider · Type 1 NPI

Bryan Allen Bloemendaal, MS, LAC

Addiction (Substance Use Disorder) Counselor · Fargo, ND

NPI number 1245784156 Active

Practice location

4215 9th Ave S
Fargo, ND 58103-2018

Mailing address

5050 40th Ave S, Apt 203
Fargo, ND 58104-8906

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X304586 (MN)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X1797 (ND)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1245784156

Bryan Allen Bloemendaal, MS, LAC's National Provider Identifier is 1245784156, issued on Aug 9, 2016. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fargo, ND. The record was last updated on Aug 29, 2016.