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NPI Code Detail

MEDICARE: MARIN RUTH MCDONOUGH

MEDICARE: MARIN RUTH MCDONOUGH
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 PathologistCFDE-198MN

General Provider Information

NPI Number : 1639036494
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIN RUTH MCDONOUGH
Provider Business Mailing Address
First Line : 2546 DUPONT AVE S APT 1
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55405-3506
Country : US
Telephone Number : 712-441-5357
Fax Number :
Provider Business Practice Location Address
First Line : 3395 PLYMOUTH RD
Second Line :
City : MINNETONKA
State : MN
Zip : 55305-3765
Country : US
Telephone Number : 952-939-0396
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ MARIN RUTH MCDONOUGH ” Practice Location

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