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Individual

MRS. BETH A WOLF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.CCC-SLP

Contact information

Practice address
3532 19TH ST S, FARGO, ND 58104-6552
(701) 293-3345
Mailing address
3532 19TH ST S, FARGO, ND 58104-6552
(701) 293-3345

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
514
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051424
ND
01
23560
BLUE CROSS BLUE SHIELD ND
ND
Enumeration date
10/12/2006
Last updated
07/09/2007
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