Healthcare Provider Details

I. General information

NPI: 1578302790
Provider Name (Legal Business Name): KAYLEE ALGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLEE VANDERHOFF

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LEWIS AVE S STE 230
WATERTOWN MN
55388-4547
US

IV. Provider business mailing address

200 LEWIS AVE S STE 230
WATERTOWN MN
55388-4547
US

V. Phone/Fax

Practice location:
  • Phone: 952-955-3323
  • Fax:
Mailing address:
  • Phone: 952-955-3323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: