Individual provider · Type 1 NPI

Mystal Rae Axtman, M.S., LPCC

Professional Counselor · Fargo, ND

NPI number 1285775569 Active

Practice location

4675 40th Ave S Ste 115
Fargo, ND 58104-4592

Call (701) 478-0906 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X472-3-1-02-164 (ND)
Professional Counselor Primary 101YP2500X472-3-1-02-164 (ND)

Professional Counselor: Definition to come...

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About NPI 1285775569

Mystal Rae Axtman, M.S., LPCC's National Provider Identifier is 1285775569, issued on Feb 9, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Fargo, ND. The record was last updated on Feb 15, 2023.