Individual
MS. KELLY ANN RIORDAN-JAESCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
80 MINNESOTA AVE, LITTLE CANADA, MN 55117-1781
(651) 481-8040
(651) 481-8649
Mailing address
698 ROY ST S, SAINT PAUL, MN 55116-1424
(651) 699-5181
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7026
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01126361
ASHA MEMBER NUMBER
MN
01
—
7026
STATE LICENSE
MN
Enumeration date
04/18/2007
Last updated
07/08/2007
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