Provider Demographics
NPI:1023263035
Name:LIMA, GERALDO B (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:GERALDO
Middle Name:B
Last Name:LIMA
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMMUNICATION DISORDERS CLINIC
Mailing Address - Street 2:500 UNIVERSITY AVE WEST
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58707-0001
Mailing Address - Country:US
Mailing Address - Phone:701-858-3030
Mailing Address - Fax:701-858-3032
Practice Address - Street 1:COMMUNICATION DISORDER CLINIC
Practice Address - Street 2:500 UNIVERSITY AVE WEST
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58707-0001
Practice Address - Country:US
Practice Address - Phone:701-858-3030
Practice Address - Fax:701-858-3032
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1032235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist