=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326982554
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. JASON JAY ARNDT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/17/2026
-----------------------------------------------------
Last Update Date | 04/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2520 12TH AVE E
-----------------------------------------------------
City | NORTH ST PAUL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55109-2420
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-748-7450
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2520 12TH AVE E
-----------------------------------------------------
City | NORTH ST PAUL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55109-2420
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-748-7450
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 09146166
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------