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Individual

BOBBI SMITH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
2835 W SAINT GERMAIN ST, SUITE 300, SAINT CLOUD, MN 56301-4743
(320) 259-4151
Mailing address
2835 W SAINT GERMAIN ST, SUITE 300, SAINT CLOUD, MN 56301-4743

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
MN7420
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18800296
MAYO MANAGEMENT ID
MN
01
275J2SM
BCBS PROVIDER ID#
MN
01
41163580956301B008
CHAMPUS
FM
01
4600583
MEDICA PROVIDER ID
MN
01
HP35262
HEALTHPARTNERS ID
MN
Enumeration date
11/29/2005
Last updated
07/08/2007
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