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Individual

MICHAELLA R WAVRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
2400 47TH AVE S, GRAND FORKS, ND 58201
(701) 746-2205
(701) 787-4354
Mailing address
PO BOX 6000, GRAND FORKS, ND 58206-6000
(701) 746-2205
(701) 787-4354

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1784
ND

Other

Enumeration date
12/16/2019
Last updated
12/16/2019
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