Individual
TRACI OHLENKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9048 PEONY LN N, MAPLE GROVE, MN 55311-4417
(763) 416-9313
Mailing address
9048 PEONY LN N, MAPLE GROVE, MN 55311-4417
(763) 416-9313
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8228
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7C664OH
BC/BS
MN
Enumeration date
09/17/2007
Last updated
09/17/2007
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