Provider Demographics
NPI:1437257490
Name:SIMONSON, FAITH H (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:H
Last Name:SIMONSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2914 26TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-5070
Mailing Address - Country:US
Mailing Address - Phone:701-232-4622
Mailing Address - Fax:701-280-0815
Practice Address - Street 1:2914 26TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-5070
Practice Address - Country:US
Practice Address - Phone:701-232-4622
Practice Address - Fax:701-280-0815
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND40080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist