Individual
KELLY ANNE SCHENK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
11800 XEON BLVD NW, COON RAPIDS, MN 55448-2061
(763) 489-3637
(763) 312-2134
Mailing address
11800 XEON BLVD NW, COON RAPIDS, MN 55448-2099
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9936
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231243300
—
MN
Enumeration date
07/14/2020
Last updated
07/14/2020
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