Provider Demographics
NPI:1578971941
Name:SCHANDER, TRISTA
Entity Type:Individual
Prefix:
First Name:TRISTA
Middle Name:
Last Name:SCHANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 W DIVIDE AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-1220
Mailing Address - Country:US
Mailing Address - Phone:701-328-8888
Mailing Address - Fax:701-328-8900
Practice Address - Street 1:1237 W DIVIDE AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-1220
Practice Address - Country:US
Practice Address - Phone:701-328-8888
Practice Address - Fax:701-328-8900
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND794-7-15-14A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional