Organization
INDEPENDENT COMMUNICATION THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE K WOOLSEY MS SLP (SLP)
(701) 740-5740
Entity
Organization
Contact information
Practice address
901 S 11TH ST, GRAND FORKS, ND 58201-4449
(701) 740-5740
(701) 795-9760
Mailing address
901 S 11TH ST, GRAND FORKS, ND 58201-4449
(701) 740-5740
(701) 795-9760
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
344
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135H8IN
BLUE CROSS OF MN
MN
01
—
20526
BLUE CROSS OF ND
ND
05
—
51425
—
ND
Enumeration date
01/18/2007
Last updated
08/22/2020
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