Individual
MARY WEYRAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2080 36TH AVE SW STE 110, MINOT, ND 58701-7597
(701) 222-3175
(701) 222-3186
Mailing address
2625 N 19TH ST, BISMARCK, ND 58503-0574
(701) 222-3175
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1278
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1278
LICENSE NUMBER
ND
05
—
1454897
—
ND
Enumeration date
08/02/2013
Last updated
03/19/2018
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