Provider Demographics
NPI:1992329742
Name:ALSETH, LIA R (CCC/SLP)
Entity type:Individual
Prefix:
First Name:LIA
Middle Name:R
Last Name:ALSETH
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:LIA
Other - Middle Name:R
Other - Last Name:MAEGI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC/SLP
Mailing Address - Street 1:1600 MILLER TRUNK HWY STE 1300
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-5640
Mailing Address - Country:US
Mailing Address - Phone:218-786-3392
Mailing Address - Fax:218-720-3415
Practice Address - Street 1:1600 MILLER TRUNK HWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-5640
Practice Address - Country:US
Practice Address - Phone:218-786-5360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-07
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5059-154235Z00000X
235Z00000X
MN518184235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist