Healthcare Provider Details

I. General information

NPI: 1649102328
Provider Name (Legal Business Name): BARB BUTHE M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 4TH AVE NW
BLOOMING PRAIRIE MN
55917-1129
US

IV. Provider business mailing address

202 4TH AVE NW
BLOOMING PRAIRIE MN
55917-1129
US

V. Phone/Fax

Practice location:
  • Phone: 507-583-4426
  • Fax:
Mailing address:
  • Phone: 651-439-2207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number358074
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: