Individual
PROF. JASON VITUS FORNWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED.S, MS CCC-SLP
Contact information
Practice address
520 S 1ST AVE, SIOUX FALLS, SD 57104-6902
(605) 336-7561
(605) 330-9820
Mailing address
520 S 1ST AVE, SIOUX FALLS, SD 57104-6902
(605) 336-7561
(605) 330-9820
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/06/2021
Last updated
08/06/2021
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