Organization
BRENNA PHAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENNA PHAM MA, CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(612) 965-5732
Entity
Organization
Contact information
Practice address
4250 BROWNDALE AVE, SAINT LOUIS PARK, MN 55416-3220
(612) 965-5732
Mailing address
4250 BROWNDALE AVE, SAINT LOUIS PARK, MN 55416-3220
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
11/06/2019
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