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Individual

MRS. MIRA BETH MERRIMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA CCC-SLP

Contact information

Practice address
4330 CEDAR LAKE RD S, ST LOUIS PARK, MN 55416-3700
(952) 381-3434
(952) 377-1430
Mailing address
4330 CEDAR LAKE RD S, ST LOUIS PARK, MN 55416-3700
(952) 381-3434
(952) 377-1430

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5807
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HP65441
HEALTH PARTNERS
MN
Enumeration date
08/18/2006
Last updated
07/08/2007
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