| Organization Name: | METRO THERAPY SPECIAL CHILDREN'S CLINIC, INC |
| NPI Number: | 1144587023 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICK TIMOTHY SULLIVAN (PRESIDENT) |
| Mailing Address: | 5155 E River Rd Ste 403 Fridley |
| State: | MN US |
| Postal Code: | 554213777 |
| Phone Number: | 7625722519 |
| Fax Number: | 7635722616 |
| NPI Enumeration Date: | 04/18/2012 |
| NPI Last Update Date: | 04/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |