Doctor Name: | JEANNE L GUNVALSON |
NPI Number: | 1225256316 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC |
License Number: | 7773 |
Business Practice Address: | 3490 Lexington Ave N Suite 305 Shoreview, MN - 551268074 |
Business Phone Number: | 6516390942 |
Business Fax Number: | 6516391718 |
Mailing Address: | 9000 Sequoia Rd, WOODBURY |
State: | MN |
Postal Code: | 551253400 |
Phone Number: | 7633506693 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2007 |
NPI Last Update Date: | 02/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 7773 |
Healthcare Provider Taxonomy: (Secondary) | Y |
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 |