Individual
TAIT ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8758 EGAN DR, SAVAGE, MN 55378-2561
(952) 443-9888
(952) 443-9804
Mailing address
1772 STEIGER LAKE LN, VICTORIA, MN 55386-7723
(952) 443-9888
(952) 443-9804
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9497
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001442700
—
MN
01
—
017J6KI
BCBS
MN
01
—
1311578
ARAZ/AMERICA'S PPO/CIGNA
MN
01
—
16154051
PT CARE
MN
01
—
169036
UCARE
MN
01
—
565581028804
PREFERRED ONE
MN
01
—
76842
HEALTH PARTNERS
MN
Enumeration date
08/12/2016
Last updated
08/12/2016
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