Individual
ANDREA KANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2705 ENLOE ST, HUDSON, WI 54016-8173
(715) 386-2128
Mailing address
108 W ELM ST, ROBERTS, WI 54023-9715
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2920
WI
235Z00000X
Speech-Language Pathologist
7716
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167861
AETNA
—
01
—
28B1AR
BCBS MN
MN
01
—
423T5AR
BLUE CROSS BLUE SHIELD
MN
05
—
42583700
—
WI
01
—
46010108
MEDICA
—
01
—
641671046996
PREFERED ONE
—
01
—
HP45694
HEALTH PARTNERS
MN
Enumeration date
09/22/2006
Last updated
02/05/2008
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