Mcgillivray, Larae A

Mcgillivray, Larae A is an individual health care provider with primary practice located at 1104 7Th Ave S Msum Box 119, Moorhead MN 56563-0001. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Mcgillivray, Larae A can be contacted via phone (218) 477-4639.

Contact Information

Primary practice address
1104 7Th Ave S Msum Box 119 Moorhead MN 56563-0001
Phone: (218) 477-4639
Fax: (218) 477-4392
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 7234 Minnesota

Profile Details

NPI number 1003908682
LBN Legal business name Mcgillivray, Larae A
Credentials MS CCCSLP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003908682 NPPES
North Dakota MEDICAID 51837
North Dakota Other 18429
North Dakota Other 61B52MC

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