Healthcare Provider Details

I. General information

NPI: 1205776424
Provider Name (Legal Business Name): DELANEY RUTH TATARKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 DIFFLEY RD
EAGAN MN
55122-2053
US

IV. Provider business mailing address

3708 DAKOTA AVE
WOODBURY MN
55125-5022
US

V. Phone/Fax

Practice location:
  • Phone: 952-707-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1044068
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: