Provider Demographics
NPI:1962840256
Name:CHILDREN'S SPEECH LANGUAGE SERVICES
Entity Type:Organization
Organization Name:CHILDREN'S SPEECH LANGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCHHALTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS/CCC-SLP
Authorized Official - Phone:701-226-7324
Mailing Address - Street 1:212 W AVENUE F
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-3503
Mailing Address - Country:US
Mailing Address - Phone:701-226-7324
Mailing Address - Fax:701-258-1369
Practice Address - Street 1:212 W AVENUE F
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3503
Practice Address - Country:US
Practice Address - Phone:701-226-7324
Practice Address - Fax:701-258-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND579261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
00154518OtherAMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION
ND579OtherND STATE BOARD OF EXAMINERS: AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY