Tonya Kay Schrader, MS CCC SLP

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

NPI 1811091176 · NPPES record last updated Jul 17, 2007

Key facts

NPI
1811091176
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
7578 (MN)
Practice address
204 Lewis Ave S
Suite 104
Watertown, MN 55388-4500
Phone
(952) 955-3323
Fax
(952) 255-8075
NPI assigned
Sep 8, 2006
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7578MNMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7578 MN Yes

Addresses

Primary practice location

204 Lewis Ave S
Suite 104
Watertown, MN 55388-4500

Mailing address

204 Lewis Ave S
Suite 104
Watertown, MN 55388-4500
Phone (952) 955-3323

Other identifiers

IdentifierTypeStateIssuer
46-01122OtherMNMEDICA
C08611048584OtherMNPREFERRED ONE
030N8SCOtherMNBCBS

Other providers in Watertown, MN

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

Sources for this page

Verify at the official NPI Registry.