Doctor Name: | ELLEN VAN TASSEL |
NPI Number: | 1891006599 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC-SLP |
License Number: | 9089 |
Business Practice Address: | 14301 Ewing Ave S Burnsville, MN - 553064885 |
Business Phone Number: | 9527465350 |
Business Fax Number: | 9527466131 |
Mailing Address: | 14301 Ewing Ave S, BURNSVILLE |
State: | MN |
Postal Code: | 553064885 |
Phone Number: | 9527465350 |
Fax Number: | 9527466131 |
NPI Enumeration Date: | 06/28/2010 |
NPI Last Update Date: | 09/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 9089 |
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 |