Individual
MRS. LETTY LEE FALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
2400 W 64TH ST, RICHFIELD, MN 55423-1001
(612) 798-8329
(612) 861-6050
Mailing address
7420 MEADOW GRASS CV S, COTTAGE GROVE, MN 55016-4590
(651) 731-5189
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7559
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044G9FA
BLUE CROSS BLUE SHIELD
MN
Enumeration date
11/14/2006
Last updated
07/08/2007
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