Forstrom, Connie R
Forstrom, Connie R is an individual health care provider with primary practice located at 850 Elm St , Elko NV 89801-3349. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Forstrom, Connie R can be contacted via phone (775) 753-8646.Contact Information
Primary practice address
850 Elm St
Elko NV 89801-3349
Phone: (775) 753-8646
Fax: (775) 777-1195
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SP-1184 | Nevada |
Profile Details
| NPI number | 1427197177 |
|---|---|
| LBN Legal business name | Forstrom, Connie R |
| Credentials | MS, CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2007 |
| Last updated | Jun 11th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427197177 | NPPES |
| New Mexico | MEDICAID | G 4815 |
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