Individual
TERESA RAE KOPPANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCCSLP
Contact information
Practice address
38100 ANTLER LN, BATTLE LAKE, MN 56515-9270
(952) 240-0551
Mailing address
PO BOX 1044, LONG BEACH, WA 98631-1044
(952) 240-0551
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
8187
MN
235Z00000X
Speech-Language Pathologist
Primary
LL60762859
WA
Other
Enumeration date
03/21/2008
Last updated
03/30/2023
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