Provider Demographics
NPI:1912326448
Name:NELSON-EGEBERG, WINDY MORIAH (MSW)
Entity type:Individual
Prefix:
First Name:WINDY
Middle Name:MORIAH
Last Name:NELSON-EGEBERG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 14TH AVE W
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-4622
Mailing Address - Country:US
Mailing Address - Phone:701-570-1317
Mailing Address - Fax:701-577-5782
Practice Address - Street 1:603 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-5317
Practice Address - Country:US
Practice Address - Phone:701-774-0749
Practice Address - Fax:701-577-5782
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical