| Doctor Name: | JOLENE MARIE CARLSON LAW |
| NPI Number: | 1447689617 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CF-SLP |
| License Number: | 8934 |
| Business Practice Address: | 15590 90th St Ne Otsego, MN - 553309452 |
| Business Phone Number: | 7637554275 |
| Business Fax Number: | 7637554261 |
| Mailing Address: | 15590 90th St Ne, OTSEGO |
| State: | MN |
| Postal Code: | 553309452 |
| Phone Number: | 7637554275 |
| Fax Number: | 7637554261 |
| NPI Enumeration Date: | 11/07/2013 |
| NPI Last Update Date: | 01/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 8934 |
| 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 |