Healthcare Provider Details

I. General information

NPI: 1184780439
Provider Name (Legal Business Name): STEPHANIE M HELGERSON MSE CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 153RD ST W
ROSEMOUNT MN
55068-4946
US

IV. Provider business mailing address

15201 CRYSTAL LAKE TER
BURNSVILLE MN
55306-5006
US

V. Phone/Fax

Practice location:
  • Phone: 952-431-8900
  • Fax:
Mailing address:
  • Phone: 952-898-4082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8097
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: