Provider Demographics
NPI:1154979953
Name:NORTH DAKOTA SPEECH AND SWALLOWING SPECIALISTS, PLLC
Entity type:Organization
Organization Name:NORTH DAKOTA SPEECH AND SWALLOWING SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRONEWOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-228-6050
Mailing Address - Street 1:PO BOX 1832
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58702-1832
Mailing Address - Country:US
Mailing Address - Phone:701-228-6050
Mailing Address - Fax:
Practice Address - Street 1:800 16TH AVE SE
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-6781
Practice Address - Country:US
Practice Address - Phone:701-228-6050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty