Individual
JENNIFER HYSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 WHITE BEAR AVE N STE 28, MAPLEWOOD, MN 55109-1324
(651) 770-8884
Mailing address
360 SPRING ST APT 218, SAINT PAUL, MN 55102-4461
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8046
MN
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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