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General NPI Number Information
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NPI Number | 1326458522
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Entity Type | Organization
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Legal Business Name | CHILDRENS SPEECH PARTNERS LLC
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Dates
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Enumeration Date | 04/28/2014
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 1650 W END BLVD SUITE 100
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-5367
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Country | US
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Telephone | 763-259-5754
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 W END BLVD SUITE 100
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-5367
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Country | US
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Telephone | 763-259-5754
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. JENNA ABERSON
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Credential | MA, CCC-SLP
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Telephone | 612-240-8293
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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 | 7806
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7880
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License Number State | MN
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