Individual
KATELYN ROSE FORNSHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 5TH AVE SW, MINOT, ND 58701-3510
(701) 857-4400
Mailing address
2000 5TH AVE SW, MINOT, ND 58701-3510
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1582
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000
—
ND
Enumeration date
10/17/2017
Last updated
10/17/2017
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