Individual
KATHERINE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2846 BRANDT DR S, FARGO, ND 58104-8805
(701) 232-2340
(701) 232-2330
Mailing address
2846 BRANDT DR S, FARGO, ND 58104-8805
(701) 232-2340
(701) 232-2330
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1151
ND
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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