MEDICARE: DENA MARIE FORNWALD MA CCC-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
1	235Z00000X	Speech-Language Pathologist	388027	MN

General Provider Information

NPI Number	:	1447104385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENA MARIE FORNWALD MA CCC-SLP

Provider Business Mailing Address
First Line	:	1300 S MONTPELIER AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57106-7743
Country	:	US
Telephone Number	:	651-439-2207
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 S MONTPELIER AVE
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57106-7743
Country	:	US
Telephone Number	:	651-439-2207
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2026
Last Update Date	:	02/26/2026

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Directions to “ DENA MARIE FORNWALD MA CCC-SLP” Practice Location

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