Organization
SPEECH PLACE LLC
Active
Other names
Speech Place
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY J PETERSON SLP (OWNER)
(218) 333-1571
Entity
Organization
Contact information
Practice address
677 ANNE ST NW, SUITE E, BEMIDJI, MN 56601-4390
(218) 333-1571
(218) 333-0948
Mailing address
29 E MAIN ST, WACONIA, MN 55387-1114
(952) 442-7015
(952) 442-7016
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7693
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
589185100
—
MN
Enumeration date
03/24/2008
Last updated
05/24/2011
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