Kristen Weidner, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Long Prairie, MN

NPI 1902255607 · NPPES record last updated Jun 3, 2016

Key facts

NPI
1902255607
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
9293 (MN)
Practice address
20 9TH St SE
Long Prairie, MN 56347-1404
Phone
(320) 732-7264
NPI assigned
Jun 3, 2016
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

State licenses

LicenseStateTypeSpecialty
9293MNMDEmergency Medical Services (Emergency Medicine) Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 9293 MN Yes

Addresses

Primary practice location

20 9TH St SE
Long Prairie, MN 56347-1404

Mailing address

20 9TH St SE
Long Prairie, MN 56347-1404
Phone (320) 732-7264

Other providers in Long Prairie, MN

All providers in Long Prairie, MN · Speech-Language Pathologist in Minnesota

Sources for this page

Verify at the official NPI Registry.