| Myna Therapy Services Pllc | |
|
4575 23rd Ave S Ste 500 Fargo ND 58104-8784 | |
| (701) 347-1782 | |
| (701) 404-8274 |
| Full Name | Myna Therapy Services Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4575 23rd Ave S Ste 500, Fargo, North Dakota |
| Authorized Official Name and Position | Elaine Doerfler (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7013471782 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Myna Therapy Services Pllc 4575 23rd Ave S Ste 500 Fargo ND 58104-8784 Ph: (701) 347-1782 | Myna Therapy Services Pllc 4575 23rd Ave S Ste 500 Fargo ND 58104-8784 Ph: (701) 347-1782 |
| NPI Number | 1427788629 |
|---|---|
| Provider Enumeration Date | 06/13/2022 |
| Last Update Date | 09/19/2024 |
| Certification Date | 09/19/2024 |
| Medicare PECOS PAC ID | 8022499888 |
|---|---|
| Medicare Enrollment ID | O20220726000211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427788629 | NPI | - | NPPES |
| Provider Name | Elaine K Doerfler |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1124388731 PECOS PAC ID: 5698923910 Enrollment ID: I20120912000035 |
| Provider Name | Katie A Hinnenkamp |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1164950846 PECOS PAC ID: 0042583726 Enrollment ID: I20170831000014 |
| Provider Name | Courtney P Crabill |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447742655 PECOS PAC ID: 9133476203 Enrollment ID: I20180719003558 |
| Provider Name | Cherae C Reeves |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891465704 PECOS PAC ID: 2668879289 Enrollment ID: I20210924001285 |
| Provider Name | Lora M Rogness |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1548601164 PECOS PAC ID: 6507234481 Enrollment ID: I20221128000632 |
| Provider Name | Aeriana Maye Olson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134812639 PECOS PAC ID: 3375900285 Enrollment ID: I20230608001739 |
| Provider Name | Amanda Kay Lynch |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1780241315 PECOS PAC ID: 1658717533 Enrollment ID: I20240313004553 |
| Provider Name | Brian Pat Connelly |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1619743697 PECOS PAC ID: 5890131619 Enrollment ID: I20240314001821 |
| Provider Name | Jaycee Jo Schmidt |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1487383097 PECOS PAC ID: 5496192668 Enrollment ID: I20240322003721 |
| Provider Name | Laikyn Pfeifle |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1396424974 PECOS PAC ID: 4981042710 Enrollment ID: I20240329000876 |
| Provider Name | Casey L Brudvik |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1487339677 PECOS PAC ID: 9133567225 Enrollment ID: I20240409002442 |
| Provider Name | Cheyenne C Olien |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1841988110 PECOS PAC ID: 2567800493 Enrollment ID: I20240410002931 |
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