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Individual

MARTHA TEGELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, CCC/SLP

Contact information

Practice address
1647 SEASHELL LN, WACONIA, MN 55387-1054
(218) 851-3050
Mailing address
1647 SEASHELL LANE, WACONIA, MN 55387-5041
(218) 851-3050

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5914
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01041419
AMERICAN SPEECH AND HEARING ASSOCIATION
01
5914
MN DEPT OF HEALTH
MN
Enumeration date
02/08/2016
Last updated
02/08/2016
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