Kelly C Heinze

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

NPI 1306328596 · NPPES record last updated Sep 4, 2018

Key facts

NPI
1306328596
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
1661 (ND)
Practice address
205 2ND Ave NE
Garrison, ND 58540-7168
Phone
(701) 463-2213
NPI assigned
Sep 4, 2018
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
1661NDMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1661 ND Yes

Addresses

Primary practice location

205 2ND Ave NE
Garrison, ND 58540-7168

Mailing address

1201 45TH Ave NW Lot 3
Garrison, ND 58540-9420

Other practice location 1

51 5th Ave NE
Garrison, ND 58540-7348
Phone (701) 463-2213

Other providers in Garrison, ND

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

Sources for this page

Verify at the official NPI Registry.