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Expression Pediatric Therapy, PLLC

Speech-Language Pathologist, in Dickinson, ND. Organization (NPI-2).

NPI number1164055513
StatusActive
Last updated in NPPESJan 21, 2024

Details

NPI
1164055513
Entity type
Organization (NPI-2)
Legal business name
Expression Pediatric Therapy, PLLC
Organization subpart
No
Enumeration date
Feb 13, 2020
Certification date
Jan 21, 2024
Last updated
Jan 21, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,––Yes
225X00000X Occupational Therapist––
363LF0000X Nurse Practitioner, Family––

Practice location

1340 W Villard St Ste A
Dickinson, ND 58601-4632

Phone 701-590-9116

Mailing address

2212 3rd St W
Dickinson, ND 58601-2414

Phone 509-981-3998

Authorized official

Mackenzie M Woodworth
Speech-Language Pathologist
5099813998

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