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NPI Code Detail

MEDICARE: CARRIE AXT SLP

MEDICARE: CARRIE AXT SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist885ND

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
125852OTHERNDBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285715854
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE AXT SLP
Provider Business Mailing Address
First Line : 806 N WASHINGTON ST
Second Line :
City : BISMARCK
State : ND
Zip : 58501-3623
Country : US
Telephone Number : 701-323-4028
Fax Number :
Provider Business Practice Location Address
First Line : 806 N WASHINGTON ST
Second Line :
City : BISMARCK
State : ND
Zip : 58501-3623
Country : US
Telephone Number : 701-323-4028
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 02/27/2015

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Directions to “ CARRIE AXT SLP” Practice Location

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