Provider Demographics
NPI:1205418043
Name:ARNESON, ALECIA LYNN (SLP)
Entity Type:Individual
Prefix:
First Name:ALECIA
Middle Name:LYNN
Last Name:ARNESON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 BROADWAY N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-2694
Mailing Address - Country:US
Mailing Address - Phone:701-277-7950
Mailing Address - Fax:
Practice Address - Street 1:1351 BROADWAY N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2694
Practice Address - Country:US
Practice Address - Phone:701-277-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist