Individual
KIRA FENSTERMACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEECH LANGUAGE PAT
Contact information
Practice address
501 MAIN STREET, EMERADO, ND 58228
(701) 594-5125
(701) 594-8180
Mailing address
516 COOPER AVENUE, SUITE 102, GRAFTON, ND 58237
(701) 352-2574
(701) 352-0188
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1867
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1867
SPEECH LICENSE NUMBER
ND
Enumeration date
09/03/2020
Last updated
01/31/2024
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