# SPEECH PLACE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Speech Place
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518139120
- **Authorized official:** NANCY J PETERSON SLP (OWNER)
- **Authorized official phone:** (218) 333-1571

## Contact information

- **Practice address:** 677 ANNE ST NW, SUITE E, BEMIDJI, MN 56601-4390
- **Practice address phone:** (218) 333-1571
- **Practice address fax:** (218) 333-0948
- **Mailing address:** 29 E MAIN ST, WACONIA, MN 55387-1114
- **Mailing address phone:** (952) 442-7015
- **Mailing address fax:** (952) 442-7016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | 7693 | MN | Yes |

## Other

- **Enumeration date:** 03/24/2008
- **Last updated:** 05/24/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 589185100 | — | MN |