Healthcare Provider Details

I. General information

NPI: 1780590711
Provider Name (Legal Business Name): BRITTNEY WOLTER SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 OLDHAM AVE
MANVEL ND
58256-4019
US

IV. Provider business mailing address

516 COOPER AVE STE 102
GRAFTON ND
58237-1512
US

V. Phone/Fax

Practice location:
  • Phone: 701-696-2212
  • Fax:
Mailing address:
  • Phone: 701-352-2574
  • Fax: 701-352-0188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3238
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: