Provider Demographics
NPI:1124388731
Name:DOERFLER, ELAINE (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:DOERFLER
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 1:1876 CHARLESWOOD ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-4203
Mailing Address - Country:US
Mailing Address - Phone:701-866-9934
Mailing Address - Fax:
Practice Address - Street 1:1876 CHARLESWOOD ESTATES DR
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-4203
Practice Address - Country:US
Practice Address - Phone:701-866-9934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1212235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist