Healthcare Provider Details

I. General information

NPI: 1265828313
Provider Name (Legal Business Name): EMILLEE PARSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILLEE HUNSTIGER

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 BASS LAKE RD STE 305
MINNEAPOLIS MN
55428-3115
US

IV. Provider business mailing address

9220 BASS LAKE RD STE 305
MINNEAPOLIS MN
55428-3115
US

V. Phone/Fax

Practice location:
  • Phone: 651-212-5104
  • Fax: 855-828-9067
Mailing address:
  • Phone: 651-212-5104
  • Fax: 855-828-9067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number9297
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: