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General NPI Number Information
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NPI Number | 1043010986
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Entity Type | Organization
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Legal Business Name | OTTER SPEECH THERAPY LLC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 123 W LINCOLN AVE STE 6
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City | FERGUS FALLS
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State | MN
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Zip | 56537-2133
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Country | US
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Telephone | 218-321-0808
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Fax |
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Provider Business Mailing Address
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Address Line | 123 W LINCOLN AVE STE 6
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City | FERGUS FALLS
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State | MN
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Zip | 56537-2133
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Country | US
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Telephone | 218-321-0808
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Fax | 218-210-7577
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | JULIA IRENE LAKODUK
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Credential | MS CCC SLP
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Telephone | 218-321-0808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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