Medicaid Provider Enrollment Attestation Licensed Baccalaureate Social Worker - North Dakota

Medicaid Provider Enrollment Attestation Licensed Baccalaureate Social Worker is a legal document that was released by the North Dakota Department of Human Services - a government authority operating within North Dakota.

Form Details:

• Released on October 14, 2021;
• The latest edition currently provided by the North Dakota Department of Human Services;
• Ready to use and print;
• Easy to customize;
• Compatible with most PDF-viewing applications;
• Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the North Dakota Department of Human Services.