Individual
MRS. HEIDI JEAN VAN DUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
215 2ND ST SE, MINOT, ND 58701-3924
(701) 857-4410
(701) 857-4413
Mailing address
215 2ND ST SE, MINOT, ND 58701-3924
(701) 857-4410
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
492
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50400
—
ND
Enumeration date
02/06/2007
Last updated
07/08/2007
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