Brianne Camilla Johnsen

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

NPI 1962562009 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1962562009
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
7745 (MN)
Practice address
109 Court Ave S
Sandstone, MN 55072-5120
Phone
(320) 245-2211
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic LTD Current Accepting new patients

Locations

1600 Miller Trunk Hwy
Ste 1300
Duluth, MN 55811
Phone (218) 786-3392

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7745 MN Yes

Addresses

Primary practice location

109 Court Ave S
Sandstone, MN 55072-5120

Mailing address

109 Court Ave S
Sandstone, MN 55072-5120
Phone (320) 245-2211

Other providers in Sandstone, MN

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

Sources for this page

Verify at the official NPI Registry.