Individual
MS. KELLY BERTENSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4415 W 36 1/2 ST, ST LOUIS PARK, MN 55416-4854
(952) 927-9717
Mailing address
7244 YORK AVE S, APARTMENT # 426, EDINA, MN 55435-4455
(612) 242-1220
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8926
MN
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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