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General NPI Number Information
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NPI Number | 1326266842
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Entity Type | Organization
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Legal Business Name | KESSLER SPEECH THERAPY SERVICES, INC.
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Dates
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Enumeration Date | 04/22/2007
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 2835 W SAINT GERMAIN ST #300
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City | SAINT CLOUD
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State | MN
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Zip | 56301-6280
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Country | US
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Telephone | 320-215-5590
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5123
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City | SAINT CLOUD
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State | MN
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Zip | 56302-5123
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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 | PRESIDENT, CEO
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Name | JODELL KESSLER
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Credential |
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Telephone | 320-251-5590
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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 | 5520
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License Number State | MN
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