Individual
AMY SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
9048 PEONY LN N, MAPLE GROVE, MN 55311-4417
(763) 416-9311
(763) 416-4530
Mailing address
21055 LAKE GEORGE BLVD, ANOKA, MN 55303-8618
(763) 238-9419
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7832
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
083H5SA
BLUE CROSS BLUE SHIELD
MN
01
—
46-01057
MEDICA
MN
Enumeration date
12/29/2006
Last updated
07/08/2007
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