Kelli Doty, MA/CCC-SLP

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

NPI 1295030906 · NPPES record last updated Jan 12, 2011

Key facts

NPI
1295030906
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
8498 (MN)
Practice address
1772 Steiger Lake LN
Suite 100
Victoria, MN 55386-7723
Phone
(952) 443-9888
NPI assigned
Jan 12, 2011
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)
Yes
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
8498MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Public Schools Speech-Language Pathologist Current Accepting new patients
Kid Talk Inc Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8498 MN Yes

Addresses

Primary practice location

1772 Steiger Lake LN
Suite 100
Victoria, MN 55386-7723

Mailing address

1772 Steiger Lake LN
Suite 100
Victoria, MN 55386-7723
Phone (952) 443-9888

Other providers in Victoria, MN

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

Sources for this page

Verify at the official NPI Registry.