Haley Amanda Blacker

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

528791 Issued in MN

Practice address

3395 Plymouth Rd
Minnetonka, MN 55305-3633

Phone

(952) 939-0396

NPI assigned

Aug 26, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Haley Amanda Barrett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1437706207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8988 PEONY LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553114445",
            "telephone_number": "936-671-1045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3395 PLYMOUTH RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053633",
            "telephone_number": "952-939-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKER",
        "first_name": "HALEY",
        "middle_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "BARRETT",
            "middle_name": "AMANDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eva Fiona Bisaso, NP
• Jeana Bisek, LICSW
• Henrik J Bjorndahl, CRNA
• BKD Project 3 Manager LLC
• Elyssa Margaret Black, LSW
• Alyson L Blakstad, OD
• Luke Joseph Blascziek
• Lexis Blaser
• Leah R Blattner, OTR/L
• Amy Beth Butler Bleeker

• Speech-Language Pathologist in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.