Individual
CONNIE R FORSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
850 ELM ST, ELKO, NV 89801-3349
(775) 753-8646
(775) 777-1195
Mailing address
307 BROOKWOOD RD, ELKO, NV 89801-2300
(775) 340-1878
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-1184
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G 4815
—
NM
Enumeration date
02/06/2007
Last updated
06/11/2011
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