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Individual

ALLI LAUREL FORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
2110 SILVER BELL RD, EAGAN, MN 55122-1024
(952) 767-4200
Mailing address
8466 144TH ST W, APPLE VALLEY, MN 55124-6528
(507) 479-0503

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
528569
MN
390200000X
Student in an Organized Health Care Education/Training Program
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14444848
AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION (ASHA)
MN
Enumeration date
05/22/2023
Last updated
04/03/2024
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