Individual
IDA ADAMS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS-CCC/SLP
Contact information
Practice address
314 MAIN ST E, SUITE 3, NEW PRAGUE, MN 56071-2448
(952) 758-5775
(952) 758-5778
Mailing address
30576 CEDAR LN, LE SUEUR, MN 56058-4346
(952) 758-5775
(952) 758-5778
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5931
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7341712
MN AETNA NUMBER
MN
01
—
93G70AD
MN BCBS NUMBER
FM
01
—
HP54088
MN HEALTHPARTNERS NUMBER
MN
Enumeration date
02/06/2006
Last updated
07/09/2007
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