Provider Demographics
NPI:1194197541
Name:JOST, ROSEMARY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:JOST
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:3212 JERSEY AVE S
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-3417
Mailing Address - Country:US
Mailing Address - Phone:815-922-8851
Mailing Address - Fax:
Practice Address - Street 1:2000 PLYMOUTH RD STE 220
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-2382
Practice Address - Country:US
Practice Address - Phone:815-922-8851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9133235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist