Organization
LAKESHORE PEDIATRIC THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN DIAZ M.S. CCC-SLP (DIRECTOR)
(612) 202-5132
Entity
Organization
Contact information
Practice address
13304 LOVELAND CIR, MINNETONKA, MN 55305-2306
(612) 202-5132
Mailing address
13304 LOVELAND CIR, MINNETONKA, MN 55305-2306
(612) 202-5132
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8141
MN
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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