Individual
THERESA KORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3514 33RD AVE W, UNIT 26, WILLISTON, ND 58801-6940
(917) 608-7368
Mailing address
3514 33RD AVE W, UNIT 26, WILLISTON, ND 58801-6940
(917) 608-7368
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1484
ND
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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