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General NPI Number Information
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NPI Number | 1528816220
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Entity Type | Individual
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Provider Name | HALEY VAN DEN BURG MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/08/2024
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1250 W BROADWAY AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55411-2533
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Country | US
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Telephone | 612-668-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 WASHINGTON AVE S APT 517
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City | MINNEAPOLIS
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State | MN
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Zip | 55454-2055
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Country | US
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Telephone | 267-377-5298
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Fax |
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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 |
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License Number State |
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