Individual
JACLYN MARTINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4215 31ST AVE S, FARGO, ND 58104-7742
(701) 478-0221
Mailing address
4215 31ST AVE S, FARGO, ND 58104-7742
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1573
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1472212
—
ND
Enumeration date
05/31/2017
Last updated
05/22/2024
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