Provider Demographics
NPI:1679054969
Name:SCHWARZHOFF, BECKY (LADC, LSW)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:
Last Name:SCHWARZHOFF
Suffix:
Gender:F
Credentials:LADC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 FRIBERG AVE STE B
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2309
Mailing Address - Country:US
Mailing Address - Phone:218-531-1528
Mailing Address - Fax:
Practice Address - Street 1:119 FRIBERG AVE STE B
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2309
Practice Address - Country:US
Practice Address - Phone:218-531-1528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10935712084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine