Kristin Ann Brodell
Individual provider Active NPI Speech-Language Pathologist · Devils Lake, ND
NPI 1609229129 · NPPES record last updated May 22, 2020
Key facts
- NPI
- 1609229129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 1511 (ND)
- Practice address
- 801 5TH Ave SE
Devils Lake, ND 58301-3649 - Phone
- (701) 662-7690
- NPI assigned
- Jul 20, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1511 | ND | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinic Pharmacy Inc | Past | Accepting new patients | |
| Lake Region Special Education | Speech-Language Pathologist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1511 | ND | Yes |
Addresses
Primary practice location
801 5TH Ave SE
Devils Lake, ND 58301-3649
Mailing address
801 5TH Ave SE
Devils Lake, ND 58301-3649
Phone (701) 662-7690
Other providers in Devils Lake, ND
- Channing Braun
- Tesha Lynn Brehm
- Brekhus Wellness, PLLC
- Madisyn Lou Brekke I
- Brenna Joy Dietitian, LLC
- Tammy Brooks
- Alexis Nicole Brown
- Heidi Brown
- Gerianne Brunelle
- Tracy Kay Buckmeier
All providers in Devils Lake, ND · Speech-Language Pathologist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.