Provider Demographics
NPI:1811664766
Name:SWENHAUGEN, KARLIE ANN (MS, CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:KARLIE
Middle Name:ANN
Last Name:SWENHAUGEN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:KARLIE
Other - Middle Name:ANN
Other - Last Name:MAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CF-SLP
Mailing Address - Street 1:4451 BLUE STEM WAY
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-7078
Mailing Address - Country:US
Mailing Address - Phone:507-828-4132
Mailing Address - Fax:
Practice Address - Street 1:20 29TH AVE NE
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-1799
Practice Address - Country:US
Practice Address - Phone:701-446-5073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1966235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist