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NPI Code Detail

MEDICARE: LAURA JANE FREESE SLP

MEDICARE:   LAURA JANE FREESE  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 Pathologist5486MN

General Provider Information

NPI Number : 1801985718
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA JANE FREESE SLP
Provider Business Mailing Address
First Line : 1250 W BROADWAY AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-2533
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1250 W BROADWAY AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55411-2533
Country : US
Telephone Number : 612-672-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 03/02/2026

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Directions to “ LAURA JANE FREESE SLP” Practice Location

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