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Individual

ROXANA D LIEBERG JORDHEIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
37 VAIL CIR, GRAND FORKS, ND 58201-5165
(701) 330-7772
Mailing address
37 VAIL CIR, GRAND FORKS, ND 58201-5165
(701) 330-7772

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
15822
OR
235Z00000X
Speech-Language Pathologist
Primary
2620
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
51030
ND
Enumeration date
06/05/2006
Last updated
06/10/2025
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