Healthcare Provider Details

I. General information

NPI: 1255254678
Provider Name (Legal Business Name): MADISON VANSANTEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 2ND AVE SW
PERHAM MN
56573-1600
US

IV. Provider business mailing address

101 S JEFFERSON AVE
BATTLE LAKE MN
56515-4133
US

V. Phone/Fax

Practice location:
  • Phone: 218-346-5437
  • Fax:
Mailing address:
  • Phone: 218-770-1285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1005249
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: