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1043563570
KELLY BERTENSHAW
ST LOUIS PARK, MN
NPI
1043563570
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: MN 8926)
Enumeration Date
2012-10-22
Last Update Date
2012-10-22
Business Address
Ms. KELLY BERTENSHAW
4415 W 36 1/2 ST
ST LOUIS PARK, MN 55416-4854
Phone number: 952-927-9717
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Mailing Address
Ms. KELLY BERTENSHAW
7244 YORK AVE S APARTMENT # 426
EDINA, MN 55435-4455
Phone number: 612-242-1220
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