Healthcare Provider Details

I. General information

NPI: 1326665951
Provider Name (Legal Business Name): CLAIRE COOTE AU.D., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 09/30/2024
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6099 WAYZATA BLVD XCHANGE MEDICAL BUILDING, STE 200
ST LOUIS PARK MN
55416
US

IV. Provider business mailing address

6099 WAYZATA BLVD XCHANGE MEDICAL BUILDING, STE 200
ST LOUIS PARK MN
55416
US

V. Phone/Fax

Practice location:
  • Phone: 612-871-1144
  • Fax: 865-544-5816
Mailing address:
  • Phone: 952-217-5843
  • Fax: 865-544-5816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number528504
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: