MEDICARE: ANNE SELBYG

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	375795	MN

General Provider Information

NPI Number	:	1588529291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE SELBYG

Provider Business Mailing Address
First Line	:	6300 WALKER ST
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-2380
Country	:	US
Telephone Number	:	952-928-6745
Fax Number	:	952-928-6742

Provider Business Practice Location Address
First Line	:	6300 WALKER ST
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-2380
Country	:	US
Telephone Number	:	952-928-6745
Fax Number	:	952-928-6742

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

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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Directions to “ ANNE SELBYG ” Practice Location

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