| NPI | 1134806037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGET RAINVILLE Speech Language Pathologist 952-200-7878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2023-07-03 |