| NPI | 1427243484 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MARK DERUITER Program Director 612-624-3322 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 231H00000X Audiologist (Licence: MN 5987) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MN 5987) | 
| Enumeration Date | 2007-09-12 | 
| Last Update Date | 2008-06-19 |