Individual
JENNIFER ANNETTE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFY
Contact information
Practice address
15620 EDGEWOOD DR STE 240, BAXTER, MN 56401-6984
(218) 454-7012
(218) 454-7015
Mailing address
309 WASHINGTON AVE, ORTONVILLE, MN 56278-1357
(320) 839-4090
(320) 839-4196
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9929
MN
Other
Enumeration date
07/19/2017
Last updated
07/19/2017
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