Healthcare Provider Details

I. General information

NPI: 1699696096
Provider Name (Legal Business Name): HAZEL FILENE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 N FERRY ST
ANOKA MN
55303-1650
US

IV. Provider business mailing address

417 HOLLY AVE
SAINT PAUL MN
55102-2203
US

V. Phone/Fax

Practice location:
  • Phone: 763-506-1000
  • Fax:
Mailing address:
  • Phone: 919-360-1860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: