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General NPI Number Information
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NPI Number | 1447759196
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Entity Type | Individual
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Provider Name | ALEXANDRA KRISTINA NODTVEDT M.A. CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 02/08/2018
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Provider Practice Location Address
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Address Line | 5710 BAKER RD
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City | MINNETONKA
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State | MN
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Zip | 55345-5901
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Country | US
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Telephone | 952-767-4230
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Fax | 952-767-4211
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Provider Business Mailing Address
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Address Line | 5710 BAKER RD
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City | MINNETONKA
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State | MN
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Zip | 55345-5901
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Country | US
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Telephone | 952-767-4230
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Fax | 952-767-4211
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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 | 10031
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License Number State | MN
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