Healthcare Provider Details

I. General information

NPI: 1619800307
Provider Name (Legal Business Name): EMILY CLAIRE SIKKINK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10273 YELLOW CIRCLE DR
MINNETONKA MN
55343-9144
US

IV. Provider business mailing address

10273 YELLOW CIRCLE DR
MINNETONKA MN
55343-9144
US

V. Phone/Fax

Practice location:
  • Phone: 952-215-3766
  • Fax: 952-401-9805
Mailing address:
  • Phone: 952-215-3766
  • Fax: 952-401-9805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberLICC-4244
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: