Individual
CHANDRA JO BUSHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC SLP
Contact information
Practice address
100 COBBLESTONE LANE, COURAGE BURNSVILLE, BURNSVILLE, MN 55306
(952) 898-5700
(952) 898-5757
Mailing address
3915 GOLDEN VALLEY RD, COURAGE CENTER, GOLDEN VALLEY, MN 55422
(952) 898-5700
(952) 898-5757
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7925
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
372G7BU
BCBS MINNESOTA
MN
01
—
4600937
MEDICA
MN
01
—
HP54024
HEALTHPARTNERS
MN
Enumeration date
10/18/2006
Last updated
07/08/2007
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