MEDICARE: TAYLOR LEA KRANTZ SPEECH THERAPIST

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
1	235Z00000X	Speech-Language Pathologist	1045484	MN

General Provider Information

NPI Number	:	1891628418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR LEA KRANTZ SPEECH THERAPIST

Provider Business Mailing Address
First Line	:	184 HIGH ST STE 701
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02110-3025
Country	:	US
Telephone Number	:	866-600-7598
Fax Number	:

Provider Business Practice Location Address
First Line	:	11600 RAVEN ST NW
Second Line	:
City	:	COON RAPIDS
State	:	MN
Zip	:	55433-3011
Country	:	US
Telephone Number	:	763-506-4800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ TAYLOR LEA KRANTZ SPEECH THERAPIST” Practice Location

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