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Individual

CARRIE AXT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
806 N WASHINGTON ST, BISMARCK, ND 58501-3623
(701) 323-4028
Mailing address
806 N WASHINGTON ST, BISMARCK, ND 58501-3623
(701) 323-4028

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
885
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
25852
BCBS
ND
05
50866
ND
Enumeration date
10/18/2006
Last updated
02/27/2015
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