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General NPI Number Information
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NPI Number | 1578406559
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Entity Type | Individual
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Provider Name | SARAH DIANE ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 04/13/2026
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 6085 7TH ST NE
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City | FRIDLEY
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State | MN
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Zip | 55432-5534
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Country | US
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Telephone | 763-502-5147
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Fax | 763-502-5140
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Provider Business Mailing Address
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Address Line | 6085 7TH ST NE
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City | FRIDLEY
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State | MN
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Zip | 55432-5534
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Country | US
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Telephone | 763-502-5147
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Fax | 763-502-5140
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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 | 12140434
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License Number State | MN
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