| 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 |