Healthcare Provider Details

I. General information

NPI: 1801726823
Provider Name (Legal Business Name): DENISE LORENTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 SCHOOL BLVD
MONTICELLO MN
55362-2976
US

IV. Provider business mailing address

9277 EDMONSON AVE NE APT 334
MONTICELLO MN
55362-2716
US

V. Phone/Fax

Practice location:
  • Phone: 763-272-3000
  • Fax:
Mailing address:
  • Phone: 763-272-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12066780
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: