Healthcare Provider Details

I. General information

NPI: 1528594496
Provider Name (Legal Business Name): MISS CHRISTINA STEINBACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINA BRACKE

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2945 HAZELWOOD ST STE 320
MAPLEWOOD MN
55109-1244
US

IV. Provider business mailing address

2945 HAZELWOOD ST STE 320
MAPLEWOOD MN
55109-1244
US

V. Phone/Fax

Practice location:
  • Phone: 651-683-7030
  • Fax: 651-683-7031
Mailing address:
  • Phone: 651-683-7030
  • Fax: 651-683-7031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberLICC-1721
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: