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NPI Code Detail

MEDICARE: RACHAEL MARY LOOK M.S, CCC-SLP

MEDICARE: RACHAEL MARY LOOK M.S, 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
1235Z00000XSpeech-Language Pathologist5245WI
2235Z00000XSpeech-Language Pathologist518226MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1518226OTHERMNMN STATE LICENSE NUMBER

General Provider Information

NPI Number : 1356918510
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHAEL MARY LOOK M.S, CCC-SLP
Provider Business Mailing Address
First Line : 12400 PORTLAND AVE STE 140
Second Line :
City : BURNSVILLE
State : MN
Zip : 55337-6805
Country : US
Telephone Number : 952-428-0400
Fax Number :
Provider Business Practice Location Address
First Line : 12400 PORTLAND AVE STE 140
Second Line :
City : BURNSVILLE
State : MN
Zip : 55337-6805
Country : US
Telephone Number : 952-428-0400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2021
Last Update Date : 06/20/2022

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Directions to “ RACHAEL MARY LOOK M.S, CCC-SLP” Practice Location

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