Provider Demographics
NPI:1063682144
Name:PFEIFER, MARNI J (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARNI
Middle Name:J
Last Name:PFEIFER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 40TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-6301
Mailing Address - Country:US
Mailing Address - Phone:701-446-3537
Mailing Address - Fax:
Practice Address - Street 1:1717 40TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-6301
Practice Address - Country:US
Practice Address - Phone:701-446-3537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND887235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist