Individual
MRS. MARIAH DUSE JESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCCSLP
Contact information
Practice address
3003 32ND AVE S, SUITE 9, FARGO, ND 58103-6163
(701) 232-2340
(701) 232-2330
Mailing address
3003 32ND AVE S, SUITE 9, FARGO, ND 58103-6163
(701) 232-2340
(701) 232-2330
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1065
ND
235Z00000X
Speech-Language Pathologist
SP38X
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770688871
—
WY
Enumeration date
08/22/2007
Last updated
02/04/2009
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