Healthcare Provider Details

I. General information

NPI: 1417883737
Provider Name (Legal Business Name): ABBIE MARSCHKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4342 15TH AVE S
FARGO ND
58103-1100
US

IV. Provider business mailing address

708 LUND AVE S
GLYNDON MN
56547-4414
US

V. Phone/Fax

Practice location:
  • Phone: 701-936-9495
  • Fax: 952-222-1994
Mailing address:
  • Phone: 701-936-9495
  • Fax: 952-222-1994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3128
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: