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General NPI Number Information
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NPI Number | 1255245742
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Entity Type | Individual
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Provider Name | RIC CALDWELL MA, CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 15 COUNTY ROAD B2 E
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City | LITTLE CANADA
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State | MN
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Zip | 55117-1401
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Country | US
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Telephone | 651-724-6621
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Fax |
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Provider Business Mailing Address
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Address Line | 201 OAK PARK DR NE
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City | BLAINE
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State | MN
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Zip | 55434-1944
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Country | US
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Telephone | 763-913-1544
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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 | 364867
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License Number State | MN
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