Individual
AMANDA PORTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
4530 NORTHERN SKY DR, BISMARCK, ND 58503-8534
(701) 751-6336
(701) 751-6337
Mailing address
1511 SHARLOH LOOP APT B, BISMARCK, ND 58501-7822
(701) 751-6336
(701) 751-6337
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1504
ND
Other
Enumeration date
06/09/2016
Last updated
10/30/2019
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