Jennifer Anderson, M.S., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Richfield, MN
NPI 1669895173 · NPPES record last updated Jul 9, 2021
Key facts
- NPI
- 1669895173
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 6625 Lyndale Ave S Ste 430
Richfield, MN 55423-2300 - Phone
- (952) 285-2840
- Fax
- (952) 285-2830
- NPI assigned
- Feb 4, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0763L | MD | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capernaum Pediatric Therapy, Inc. | Current |
Accepting new patients |
Locations
6625 Lyndale Ave S
Ste 430
Richfield, MN 55423
Phone (952) 285-2840
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 0763L | MD | |
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
6625 Lyndale Ave S Ste 430
Richfield, MN 55423-2300
Mailing address
6625 Lyndale Ave S Ste 430
Richfield, MN 55423-2300
Phone (952) 285-2840
Other providers in Richfield, MN
- Brittany Marie Alvarez
- America'S Best Contacts and Eyeglasses, Inc.
- Amiin Car Services LLC
- Collier Lee Amundson
- Zofia Anderson-Kita
- Joyce Johnson Anderson
- Kiersten Lynn Anderson
- Maria Larue Anderson
- Simon Anderson
- Angela K Saeger, LLC
All providers in Richfield, 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 Jul 9, 2021. 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.