Individual
SARA PODSHIVAYLOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9346 OAK AVE, WACONIA, MN 55387-9422
(952) 223-2506
Mailing address
10273 YELLOW CIRCLE DR, MINNETONKA, MN 55343-9144
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/05/2020
Last updated
01/11/2023
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