Healthcare Provider Details

I. General information

NPI: 1851218556
Provider Name (Legal Business Name): SIERRA RIVERS NORDLOEF SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 UNIVERSITY AVE STE 203
WILLISTON ND
58801-5618
US

IV. Provider business mailing address

PO BOX 217
POWERS LAKE ND
58773-0217
US

V. Phone/Fax

Practice location:
  • Phone: 701-580-8788
  • Fax: 701-609-5231
Mailing address:
  • Phone: 701-217-0096
  • Fax: 701-609-5231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3102
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: