Kayla Braun

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

NPI 1083969786 · NPPES record last updated Mar 17, 2014

Key facts

NPI
1083969786
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
1891 Station Pkwy NW
Andover, MN 55304-4259
Phone
(763) 755-4275
NPI assigned
Jul 18, 2012
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
9257MNMDPhysical Therapist

Specialties & licenses

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

Addresses

Primary practice location

1891 Station Pkwy NW
Andover, MN 55304-4259

Mailing address

1891 Station Pkwy NW
Andover, MN 55304-4259

Other providers in Andover, MN

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

Sources for this page

Verify at the official NPI Registry.