Individual
MRS. KELLY C HEINZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 2ND AVE NE, GARRISON, ND 58540-7168
(701) 463-2213
Mailing address
1201 45TH AVE NW LOT 3, GARRISON, ND 58540-9420
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1661
ND
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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