Provider Demographics
NPI:1386493393
Name:PAPIC ZELLNER, ALYSSE ELIZABETH (MA)
Entity type:Individual
Prefix:
First Name:ALYSSE
Middle Name:ELIZABETH
Last Name:PAPIC ZELLNER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 13TH ST W
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-3549
Mailing Address - Country:US
Mailing Address - Phone:701-690-2760
Mailing Address - Fax:
Practice Address - Street 1:135 SIMS ST STE 202
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-5148
Practice Address - Country:US
Practice Address - Phone:701-380-7057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND140412124A101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor