Provider Demographics
NPI:1376989855
Name:QUOTABLE KIDS PEDIATRIC THERAPY CLINIC, PLLC
Entity Type:Organization
Organization Name:QUOTABLE KIDS PEDIATRIC THERAPY CLINIC, PLLC
Other - Org Name:QUOTABLE KIDS SPEECH AND LANGUAGE CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLK
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:701-741-8057
Mailing Address - Street 1:2600 DEMERS AVENUE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201
Mailing Address - Country:US
Mailing Address - Phone:701-739-5437
Mailing Address - Fax:701-746-9198
Practice Address - Street 1:2600 DEMERS AVENUE
Practice Address - Street 2:SUITE 101
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201
Practice Address - Country:US
Practice Address - Phone:701-739-5437
Practice Address - Fax:701-746-9198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X, 261QM1300X, 261QP2000X
ND1070261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1450553Medicaid
NDN718884Medicare UPIN