Healthcare Provider Details

I. General information

NPI: 1255259826
Provider Name (Legal Business Name): SYDNEY HOPKINS MA CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12082 QUAIL AVE N
STILLWATER MN
55082-5777
US

IV. Provider business mailing address

12082 QUAIL AVE N
STILLWATER MN
55082-5777
US

V. Phone/Fax

Practice location:
  • Phone: 765-318-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22006553A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: