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General NPI Number Information
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NPI Number | 1235089707
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Entity Type | Individual
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Provider Name | LOUISA WARREN
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Gender | Female
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 2555 COUNTY ROAD E E # 102
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55110-4906
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Country | US
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Telephone | 651-683-2953
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Fax |
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Provider Business Mailing Address
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Address Line | 4790 CENTERVILLE RD APT 219
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City | WHITE BEAR LAKE
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State | MN
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Zip | 55127-2319
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Country | US
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Telephone |
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Fax |
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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 | CFDE-203
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License Number State | MN
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