Healthcare Provider Details

I. General information

NPI: 1841155017
Provider Name (Legal Business Name): REBECCA LEE BURUD-KOLANDER SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 3RD ST
JACKSON MN
56143-1746
US

IV. Provider business mailing address

1720 S CLIFF AVE
SIOUX FALLS SD
57105-2129
US

V. Phone/Fax

Practice location:
  • Phone: 507-847-4333
  • Fax:
Mailing address:
  • Phone: 605-334-5630
  • Fax: 605-332-5327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7320
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: