Healthcare Provider Details

I. General information

NPI: 1326982265
Provider Name (Legal Business Name): LANEY LEMERE CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5985 RICE CREEK PKWY STE 205
SHOREVIEW MN
55126-5037
US

IV. Provider business mailing address

5985 RICE CREEK PKWY STE 205
SHOREVIEW MN
55126-5037
US

V. Phone/Fax

Practice location:
  • Phone: 612-888-4757
  • Fax: 612-808-0005
Mailing address:
  • Phone: 612-888-4757
  • Fax: 612-808-0005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberLICC-4302
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: