Organization
KIDSPEAK LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRISTA KRISTA MA CCC-SLP (OWNER, SPEECH PATHOLOGIST)
(763) 416-9313
Entity
Organization
Contact information
Practice address
4325 WOODHILL RD, MINNETONKA, MN 55345-2958
(763) 416-9313
(763) 416-4530
Mailing address
4325 WOODHILL RD, MINNETONKA, MN 55345-2958
(763) 416-9313
(763) 416-4530
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41M60KI
BLUE CROSS BLUE SHIELD
MN
01
—
84491
HEALTHPARTNERS
MN
Enumeration date
12/28/2006
Last updated
11/22/2023
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