Doctor Name: | MRS. KALLIE MAASS |
NPI Number: | 1447626270 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 9488 |
Business Practice Address: | 150 Cobblestone Ln Burnsville, MN - 553374578 |
Business Phone Number: | 9524604947 |
Business Fax Number: | |
Mailing Address: | 619 N Aspen Ct, SAINT PETER |
State: | MN |
Postal Code: | 560821659 |
Phone Number: | 5074201451 |
Fax Number: | |
NPI Enumeration Date: | 08/17/2015 |
NPI Last Update Date: | 08/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 9488 |
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 |