Organization
MIDWEST MYOFUNCTIONAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY L. CHOUNARD MA, CCC-CLP, COM (OWNER, CEO)
(952) 994-3913
Entity
Organization
Contact information
Practice address
11670 FOUNTAINS DR. N, SUITE 200, MAPLE GROVE, MN 55369
(952) 994-9313
Mailing address
11670 FOUNTAINS DR. N, SUITE 200, MAPLE GROVE, MN 55369
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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