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Individual

BAO DANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
812 HOLTON ST, SAINT PAUL, MN 55104-1317
(915) 777-5714
Mailing address
812 HOLTON ST, SAINT PAUL, MN 55104-1317

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9845
MN
235Z00000X
Speech-Language Pathologist
SP-982
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9845
MINNESOTA DEPARTMENT OF HEALTH
MN
01
SP-982
WYOMING STATE BOARD OF EXAMINERS OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
WY
Enumeration date
10/10/2018
Last updated
10/10/2018
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