Healthcare Provider Details

I. General information

NPI: 1467900746
Provider Name (Legal Business Name): KARLEE SMITH CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARLEE HEITMAN

II. Dates (important events)

Enumeration Date: 09/15/2016
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 E 2ND ST
DULUTH MN
55805-1906
US

IV. Provider business mailing address

400 E 3RD ST
DULUTH MN
55805-1951
US

V. Phone/Fax

Practice location:
  • Phone: 218-786-8364
  • Fax:
Mailing address:
  • Phone: 218-786-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberLICC-4428
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: