Individual
SAMANTHA IMDIEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CF-SLP
Contact information
Practice address
2401 DEMERS AVE, GRAND FORKS, ND 58201-4183
(701) 780-1891
(701) 780-4477
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201-4183
(701) 780-1891
(701) 780-4477
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2142
ND
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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