Provider Demographics
NPI:1275813495
Name:SCHRAG, ALICIA A (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:A
Last Name:SCHRAG
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 1:14050 NICOLLET AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-5710
Mailing Address - Country:US
Mailing Address - Phone:952-993-8487
Mailing Address - Fax:
Practice Address - Street 1:14050 NICOLLET AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-5710
Practice Address - Country:US
Practice Address - Phone:952-993-8487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8645235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist