Individual
ALICIA WOLSTENHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
238 1ST AVE NE, HAZEN, ND 58545
(701) 748-6383
Mailing address
BOX E, HAZEN, ND 58545
(701) 748-6383
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
846
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54445
—
ND
Enumeration date
01/17/2007
Last updated
07/08/2007
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