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General NPI Number Information
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NPI Number | 1215055660
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Entity Type | Individual
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Provider Name | SUZANNE JANELLE FEIERTAG SLP
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 709 UNIVERSITY AVE W
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City | SAINT PAUL
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State | MN
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Zip | 55104-4804
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Country | US
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Telephone | 651-227-8471
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Fax | 651-265-2318
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Provider Business Mailing Address
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Address Line | 709 UNIVERSITY AVE W
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City | SAINT PAUL
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State | MN
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Zip | 55104-4804
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Country | US
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Telephone | 651-227-8471
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Fax | 651-265-2318
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7251
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License Number State | MN
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