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NPI Code Detail

MEDICARE: DANNEKA MILLER HALVERSON CCC-SLP

MEDICARE: DANNEKA MILLER HALVERSON CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist9277MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19277OTHERMNMN DEPARTMENT OF HEALTH

General Provider Information

NPI Number : 1134509417
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANNEKA MILLER HALVERSON CCC-SLP
Provider Business Mailing Address
First Line : 5621 COUNTY ROAD 101
Second Line :
City : MINNETONKA
State : MN
Zip : 55345-4214
Country : US
Telephone Number : 952-401-5000
Fax Number :
Provider Business Practice Location Address
First Line : 5621 COUNTY ROAD 101
Second Line :
City : MINNETONKA
State : MN
Zip : 55345-4214
Country : US
Telephone Number : 952-401-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2015
Last Update Date : 05/14/2026

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Directions to “ DANNEKA MILLER HALVERSON CCC-SLP” Practice Location

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