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General NPI Number Information
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NPI Number | 1508146275
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Entity Type | Organization
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Legal Business Name | KID TALK INC
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Dates
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Enumeration Date | 08/25/2011
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Last Update Date | 08/25/2011
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Provider Practice Location Address
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Address Line | 14070 COMMERCE AVE NE SUITE 200
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City | PRIOR LAKE
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State | MN
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Zip | 55372-1424
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Country | US
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Telephone | 952-443-9888
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Fax | 952-443-9804
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Provider Business Mailing Address
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Address Line | 1772 STEIGER LAKE LN SUITE 100
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City | VICTORIA
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State | MN
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Zip | 55386-7723
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Country | US
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Telephone | 952-443-9888
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Fax | 952-443-9804
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. CANDACE MARIE ALMQUIST
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Credential | MA/CCC-SLP
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Telephone | 952-443-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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