Individual
MRS. JUDITH ANN DYRENFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEECH PATHOLOGIST
Contact information
Practice address
398 HAMILTON AVE, FAIRBANKS, AK 99701-3537
(907) 374-4911
(907) 374-4934
Mailing address
398 HAMILTON AVE, FAIRBANKS, AK 99701-3537
(907) 374-4911
(907) 374-4934
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
460
AK
235Z00000X
Speech-Language Pathologist
SP-1944
ME
Other
Enumeration date
11/05/2009
Last updated
10/17/2013
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