Individual
TYRA HEISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 36TH AVE S STE 200, FARGO, ND 58104-5275
(701) 532-1507
Mailing address
4500 36TH AVE S STE 200, FARGO, ND 58104-5275
(701) 532-1507
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/25/2024
Last updated
06/25/2024
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