Rosanne Lysne

Individual provider Active NPI Speech-Language Pathologist · Wahpeton, ND

NPI 1033523907 · NPPES record last updated Jun 18, 2014

Key facts

NPI
1033523907
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
1328 (ND)
Practice address
18055 79 1/2 St SE
Wahpeton, ND 58075-9340
Phone
(701) 642-3375
NPI assigned
Jun 18, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1328NDMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1328 ND Yes

Addresses

Primary practice location

18055 79 1/2 St SE
Wahpeton, ND 58075-9340

Mailing address

18055 79 1/2 St SE
Wahpeton, ND 58075-9340

Other providers in Wahpeton, ND

All providers in Wahpeton, ND · Speech-Language Pathologist in North Dakota

Sources for this page

Verify at the official NPI Registry.