Individual
TERAH MANDERFELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2000 OAKDALE AVE, WEST ST PAUL, MN 55118-4662
(651) 554-9500
Mailing address
1223 OTTAWA AVE, WEST ST PAUL, MN 55118-2009
(715) 571-5056
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10112
MN
235Z00000X
Speech-Language Pathologist
5095-154
WI
Other
Enumeration date
08/07/2018
Last updated
01/11/2025
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