MEDICARE: MRS. ANGELA DIANE KLEINEDLER MA 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
1	235Z00000X	Speech-Language Pathologist		MN

General Provider Information

NPI Number	:	1467773135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA DIANE KLEINEDLER MA CCC-SLP

Provider Business Mailing Address
First Line	:	9245 MAAS DR
Second Line	:
City	:	MINNETRISTA
State	:	MN
Zip	:	55375-4405
Country	:	US
Telephone Number	:	763-294-0724
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	:	952-401-6808
Fax Number	:	952-401-4022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2010
Last Update Date	:	04/02/2026

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Directions to “ MRS. ANGELA DIANE KLEINEDLER MA CCC-SLP” Practice Location

Language	Start Address	Practice Location

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