Provider Demographics
NPI:1114271541
Name:LINDGREN, ANNE R (CCC, SLP)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:R
Last Name:LINDGREN
Suffix:
Gender:F
Credentials:CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 W 7TH STRRET
Mailing Address - Street 2:
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102
Mailing Address - Country:US
Mailing Address - Phone:651-225-4558
Mailing Address - Fax:651-225-9474
Practice Address - Street 1:3001 HARBOR LN N
Practice Address - Street 2:SUITE 120
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-5102
Practice Address - Country:US
Practice Address - Phone:763-551-3652
Practice Address - Fax:763-551-1334
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7719235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist