Individual
AMY M ANDERSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
309 HOLLY LN, MANKATO, MN 56001-6274
(507) 388-5437
(507) 388-2108
Mailing address
309 HOLLY LN, MANKATO, MN 56001-6274
(507) 388-5437
(507) 388-2108
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6103
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4607115
MEDICA INDIV PROVIDER #
MN
01
—
8G446AN
BCBS INDIV PROVIDER #
MN
Enumeration date
01/30/2006
Last updated
07/08/2007
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