Individual
LAURA GUNDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
2395 ARIEL ST N, MAPLEWOOD, MN 55109-2248
(651) 773-3208
Mailing address
1004 JAMESON ST, SAINT PAUL, MN 55103-1448
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9630
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9630
MINNESOTA SPEECH-LANGUAGE PATHOLOGIST LICENSE
MN
Enumeration date
09/14/2016
Last updated
09/14/2016
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