Provider Demographics
NPI:1922345032
Name:KROGSTAD, MARIT MESNA (MA-CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIT
Middle Name:MESNA
Last Name:KROGSTAD
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 1:945 7TH AVE W
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-1429
Mailing Address - Country:US
Mailing Address - Phone:701-356-2110
Mailing Address - Fax:
Practice Address - Street 1:945 7TH AVE W
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-1429
Practice Address - Country:US
Practice Address - Phone:701-356-2110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1251235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist