| NPI | 1043644784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M JENSEN Speech Language Pathologist 651-784-7007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 9165) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-08-29 |