Lori Braiedy, MA CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Mora, MN
NPI 1124728209 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1124728209
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 397492 (MN)
- Practice address
- 2617 Chris Haven Dr
Mora, MN 55051-6541 - Phone
- (218) 391-1862
- NPI assigned
- Mar 7, 2023
- 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)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 397492 | MN | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 397492 | MN | Yes |
Addresses
Primary practice location
2617 Chris Haven Dr
Mora, MN 55051-6541
Mailing address
200 9TH St N
Mora, MN 55051-1147
Phone (320) 679-6200
Other providers in Mora, MN
- Susan Dorothy Blom
- Mary Kay Borgstrom
- Brenda Ann Bosaaen
- Randall A Bostrom
- Shelley Bragelman
- Sadie Briana Broekemeier
- Joseph John Buckley
- Aimee Burk
- Tanya Lynn Carlson
- Roberta Lorraine Casaday
All providers in Mora, MN · Speech-Language Pathologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.