Kaitlin Patricia Anderson, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Bloomington, MN

NPI 1083380869 · NPPES record last updated Aug 25, 2021

Key facts

NPI
1083380869
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
1801 American Blvd E
Bloomington, MN 55425-1232
Phone
(612) 861-1688
NPI assigned
Aug 20, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Fraser Past
since Aug 1, 2021
Accepting new patients
Fraser Child and Family Center Past
since Aug 1, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Yes

Addresses

Primary practice location

1801 American Blvd E
Bloomington, MN 55425-1232

Mailing address

4317 29TH Ave S
Minneapolis, MN 55406-3706
Phone (612) 598-6790

Other providers in Bloomington, MN

All providers in Bloomington, MN · Speech-Language Pathologist in Minnesota

Sources for this page

Verify at the official NPI Registry.