Doctor Name: | MR. ERIC CLEO GARDNER |
NPI Number: | 1851521454 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS CFY-SLP |
License Number: | 8512 |
Business Practice Address: | 7900 W 28th St St Louis Park, MN - 554263011 |
Business Phone Number: | 9529208380 |
Business Fax Number: | |
Mailing Address: | 7900 W 28th St, ST LOUIS PARK |
State: | MN |
Postal Code: | 554263011 |
Phone Number: | 9529208380 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2009 |
NPI Last Update Date: | 07/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 8512 |
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 |