Doctor Name: | CORRIN RADER |
NPI Number: | 1770729477 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSCFYSLP |
License Number: | 8332 |
Business Practice Address: | 490 Highway 96 W Suite 300 Shoreview, MN - 551261961 |
Business Phone Number: | 6514513016 |
Business Fax Number: | 6514817040 |
Mailing Address: | 490 Highway 96 W, Suite 300 SHOREVIEW |
State: | MN |
Postal Code: | 551261961 |
Phone Number: | 6514513016 |
Fax Number: | 6514817040 |
NPI Enumeration Date: | 12/30/2008 |
NPI Last Update Date: | 09/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 8332 |
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 |