Healthcare Provider Details

I. General information

NPI: 1245315027
Provider Name (Legal Business Name): KID TALK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1772 STEIGER LAKE LANE
VICTORIA MN
55386
US

IV. Provider business mailing address

PO BOX 34 1772 STIEGER LAKE LANE
VICTORIA MN
55386
US

V. Phone/Fax

Practice location:
  • Phone: 952-443-9888
  • Fax: 952-443-9804
Mailing address:
  • Phone: 952-443-9888
  • Fax: 952-443-9804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. CANDACE MARIE ALMQUIST
Title or Position: DIRECTOR
Credential: M.A./CCC-SLP
Phone: 952-443-9888