Provider Demographics
NPI:1235577362
Name:STOLTMAN, BRITTANY (SLP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:STOLTMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 9TH ST W
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MN
Mailing Address - Zip Code:56510-1279
Mailing Address - Country:US
Mailing Address - Phone:218-784-5000
Mailing Address - Fax:218-784-3753
Practice Address - Street 1:645 33RD AVE E
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8074
Practice Address - Country:US
Practice Address - Phone:701-478-7868
Practice Address - Fax:701-356-7005
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9108235Z00000X
ND1499235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist