Individual
MRS. LAURENE HEINTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
500 2 ST N, FESSENDEN, ND 58438-0067
(701) 547-3296
Mailing address
PO BOX 67, FESSENDEN, ND 58438-0067
(701) 547-3296
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
172
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019015
—
ND
Enumeration date
02/02/2007
Last updated
07/09/2007
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