Healthcare Provider Details

I. General information

NPI: 1699602862
Provider Name (Legal Business Name): KATHLEEN BRESNAHAN SCHOLTES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 2ND ST S
WAITE PARK MN
56387-2325
US

IV. Provider business mailing address

1437 ASPEN LN
SAINT CLOUD MN
56303-4898
US

V. Phone/Fax

Practice location:
  • Phone: 320-370-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number01086468
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: