Individual
MRS. TONYA KAY SCHRADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
204 LEWIS AVE S, SUITE 104, WATERTOWN, MN 55388-4500
(952) 955-3323
(952) 255-8075
Mailing address
204 LEWIS AVE S, SUITE 104, WATERTOWN, MN 55388-4500
(952) 955-3323
(952) 255-8075
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7578
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030N8SC
BCBS
MN
01
—
46-01122
MEDICA
MN
01
—
C08611048584
PREFERRED ONE
MN
Enumeration date
09/08/2006
Last updated
07/17/2007
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