Individual
TRACY W CAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS/CCC-SLP
Contact information
Practice address
2101 ROLLING GREEN LN, NORTH MANKATO, MN 56003-4442
(507) 385-1997
Mailing address
5868 BAKER RD, MINNETONKA, MN 55345-5903
(952) 767-4200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9843
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9843
MINNESOTA LICENSE
MN
Enumeration date
02/02/2018
Last updated
10/26/2022
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