Healthcare Provider Details

I. General information

NPI: 1003313784
Provider Name (Legal Business Name): RENEE BARRETT MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 HIGH SITE DR APT 213
EAGAN MN
55121-2727
US

IV. Provider business mailing address

1320 HIGH SITE DR
EAGAN MN
55121-2709
US

V. Phone/Fax

Practice location:
  • Phone: 651-245-0526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: