Individual
MRS. STACEY EHRHARDT KOENIGSFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2495 MAPLEWOOD DR STE 313, MAPLEWOOD, MN 55109-1985
(651) 770-8884
(651) 770-8151
Mailing address
2495 MAPLEWOOD DR STE 313, MAPLEWOOD, MN 55109-1985
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8577
MN
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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