Doctor Name: | MARJORIE CARLSON |
NPI Number: | 1740601343 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC-SLP |
License Number: | 9186 |
Business Practice Address: | 6936 Garland Ln N Maple Grove, MN - 553114642 |
Business Phone Number: | 7634169313 |
Business Fax Number: | 7634164530 |
Mailing Address: | 6936 Garland Ln N, MAPLE GROVE |
State: | MN |
Postal Code: | 553114642 |
Phone Number: | 7634169313 |
Fax Number: | 7634164530 |
NPI Enumeration Date: | 12/27/2013 |
NPI Last Update Date: | 12/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 9186 |
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 |