Healthcare Provider Details

I. General information

NPI: 1699427609
Provider Name (Legal Business Name): AMANDA SCHULTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2022
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 HIGHWAY 7
HOPKINS MN
55305-4737
US

IV. Provider business mailing address

2635 GIRARD AVE S APT 310
MINNEAPOLIS MN
55408-1148
US

V. Phone/Fax

Practice location:
  • Phone: 952-988-4000
  • Fax: 952-988-4092
Mailing address:
  • Phone: 641-425-2674
  • 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: