Doctor Name: | MRS. BREANN WEDIN |
NPI Number: | 1639516370 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, SLP |
License Number: | 8970 |
Business Practice Address: | 1107 Hart Blvd Ste 10 Monticello, MN - 553628539 |
Business Phone Number: | 7632956878 |
Business Fax Number: | |
Mailing Address: | 633 Main St Nw, Apt 206 ELK RIVER |
State: | MN |
Postal Code: | 553301743 |
Phone Number: | 3202244248 |
Fax Number: | |
NPI Enumeration Date: | 06/03/2013 |
NPI Last Update Date: | 06/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 8970 |
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 |