Healthcare Provider Details

I. General information

NPI: 1609523620
Provider Name (Legal Business Name): RHIAN CAILIN SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2022
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 W SAINT GERMAIN ST
SAINT CLOUD MN
56301-6280
US

IV. Provider business mailing address

2835 W SAINT GERMAIN ST
SAINT CLOUD MN
56301-6280
US

V. Phone/Fax

Practice location:
  • Phone: 320-259-4151
  • Fax:
Mailing address:
  • Phone: 320-259-4151
  • Fax: 320-774-3918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberLICC-4343
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: