Individual
VICKI M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
401 PHALEN BLVD, SAINT PAUL, MN 55130-5302
(651) 254-8570
(651) 254-8566
Mailing address
8170 33RD AVE S, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
5447
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066865600
—
MN
Enumeration date
02/08/2006
Last updated
03/08/2021
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