Provider Demographics
NPI:1306065297
Name:GETZ, TRISHA SUE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:SUE
Last Name:GETZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 SHINAGLE DR
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-4201
Mailing Address - Country:US
Mailing Address - Phone:701-483-9993
Mailing Address - Fax:
Practice Address - Street 1:683 STATE AVE STE B
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-4660
Practice Address - Country:US
Practice Address - Phone:701-483-9400
Practice Address - Fax:701-483-9398
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND823235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND52114Medicaid
ND12229OtherSLP BCBS
ND356513Medicare ID - Type UnspecifiedSLP