Individual
MICHELLE LYNN WIERSMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
11900 WAYZATA BLVD STE 132, MINNETONKA, MN 55305-2018
(952) 236-6188
Mailing address
4101 PARKLAWN AVE APT 120, EDINA, MN 55435-4660
(651) 769-5672
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8402
MN
Other
Enumeration date
03/24/2010
Last updated
03/24/2010
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