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General NPI Number Information
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NPI Number | 1235356973
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Entity Type | Individual
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Provider Name | STACIE S.E. RAMTHUN M.S., CCC
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Gender | Female
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 561 7TH ST W
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City | SAINT PAUL
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State | MN
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Zip | 55102-3009
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Country | US
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Telephone | 651-225-4558
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Fax |
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Provider Business Mailing Address
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Address Line | 1018 KINNICKINNIC ST.
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City | HUDSON
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State | MN
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Zip | 55401
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Country | US
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Telephone | 715-381-3536
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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 | 66283
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License Number State | MN
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