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NPI Code Detail

MEDICARE: LAKE REGION SPECIAL EDUCATION

MEDICARE: LAKE REGION SPECIAL EDUCATION
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
1103T00000XPsychologist
2225100000XPhysical Therapist
3235Z00000XSpeech-Language Pathologist
4225X00000XOccupational Therapist

General Provider Information

NPI Number : 1902904121
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE REGION SPECIAL EDUCATION
Provider Business Mailing Address
First Line : 801 5TH AVE SE
Second Line :
City : DEVILS LAKE
State : ND
Zip : 58301-3649
Country : US
Telephone Number : 701-662-7690
Fax Number : 701-662-7684
Provider Business Practice Location Address
First Line : 801 5TH AVE SE
Second Line :
City : DEVILS LAKE
State : ND
Zip : 58301-3649
Country : US
Telephone Number : 701-662-7690
Fax Number : 701-662-7684
Authorized Official
Title or Position : DIRECTOR
Name : MRS. CONNIE HOVENDICK
Credential :
Telephone Number : 701-662-7690
Provider Enumeration Date : 09/20/2006
Last Update Date : 09/11/2025

Similar Medicare Providers

1760549968 — DIANE MARIE LIPPERT OTR-L
Practice Location Address:
801 5TH AVE SE
DEVILS LAKE, ND
58301-3649
Practice Phone: 701-662-7690
Practice Fax: 701-662-7684
1245389469 — MRS. SHEILA HALVORSON MS CCC SLP
Practice Location Address:
801 5TH AVE SE
DEVILS LAKE, ND
58301-3649
Practice Phone: 701-662-7690
Practice Fax: 701-662-7684
1568511517 — MRS. BEVERLY A. MACK M.S.,CCC-SLP
Practice Location Address:
801 5TH AVE SE
DEVILS LAKE, ND
58301-3649
Practice Phone: 701-662-7690
Practice Fax: 701-662-7684
1821140427 — RACHELLE ROMFO MS-CCCSP
Practice Location Address:
801 5TH AVE SE
DEVILS LAKE, ND
58301-3649
Practice Phone: 701-662-7690
Practice Fax: 701-662-7684
1306998844 — MRS. STEPHANIE LIN HODOUS MS CCCSLP
Practice Location Address:
801 5TH AVE SE
DEVILS LAKE, ND
58301-3649
Practice Phone: 701-662-7690
Practice Fax: 701-662-7684
1831337302 — MRS. JENNIFER HEISLER MS CCC-SP
Practice Location Address:
801 5TH AVE SE
DEVILS LAKE, ND
58301-3649
Practice Phone: 701-662-7690
Practice Fax: 701-662-7684

Directions to “LAKE REGION SPECIAL EDUCATION ” Practice Location

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