Individual
DIANE WOOLSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
901 S 11TH ST, GRAND FORKS, ND 58201-4449
(763) 689-5385
Mailing address
901 S 11TH ST, GRAND FORKS, ND 58201-4449
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
344
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
092M7WO
BCBS
MN
01
—
094M6WO
BCBS
MN
01
—
23467
BCBS
ND
05
—
51425
—
ND
Enumeration date
10/19/2006
Last updated
07/08/2007
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