Healthcare Provider Details

I. General information

NPI: 1336054972
Provider Name (Legal Business Name): EMILY PLETSCHER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 5TH AVE S
SOUTH ST PAUL MN
55075-2332
US

IV. Provider business mailing address

104 5TH AVE S
SOUTH ST PAUL MN
55075-2332
US

V. Phone/Fax

Practice location:
  • Phone: 651-457-9400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number475319
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: