Tara L Nogowski

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

NPI 1285656389 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1285656389
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
911 (ND)
Practice address
11 North Main Street
Gwinner, ND 58040-0586
Phone
(701) 678-2244
Fax
(701) 678-2210
NPI assigned
Jul 25, 2006
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
911NDMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 911 ND Yes

Addresses

Primary practice location

11 North Main Street
Gwinner, ND 58040-0586

Mailing address

11 North Main Street
Gwinner, ND 58040-0586
Phone (701) 678-2244

Other identifiers

IdentifierTypeStateIssuer
51065MedicaidND

Other names

  • Tara L Decker Former name

Other providers in Gwinner, ND

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

Sources for this page

Verify at the official NPI Registry.