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Individual

TARA WITTROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC/SLP

Contact information

Practice address
4791 COUNTY ROAD 10 STE 102, MOOSE LAKE, MN 55767-9221
(218) 485-2020
(218) 485-2044
Mailing address
1939 MINNEHAHA AVE W STE 300, SAINT PAUL, MN 55104-1033
(651) 748-4338
(651) 748-2892

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9592
MN

Other

Enumeration date
06/06/2014
Last updated
08/14/2023
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