Organization
MIDWEST MOBILE FEES ASSESSMENTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO WEBB CALDWELL II M.ED., CCC-SLP (PRESIDENT)
(612) 803-5038
Entity
Organization
Contact information
Practice address
3514 LYNDALE AVE N, MINNEAPOLIS, MN 55412-2558
(612) 803-5038
Mailing address
3514 LYNDALE AVE N, MINNEAPOLIS, MN 55412-2558
(612) 803-5038
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9068
MN
Other
Enumeration date
01/15/2014
Last updated
11/01/2021
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