Provider Demographics
NPI:1326059536
Name:ACE SPEECH AND LANGUAGE CLINIC, LLC
Entity Type:Organization
Organization Name:ACE SPEECH AND LANGUAGE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAUER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC
Authorized Official - Phone:651-222-7768
Mailing Address - Street 1:1133 RANKIN ST
Mailing Address - Street 2:SUITE 221
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-3141
Mailing Address - Country:US
Mailing Address - Phone:651-222-7768
Mailing Address - Fax:651-698-8994
Practice Address - Street 1:1133 RANKIN ST
Practice Address - Street 2:SUITE 221
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-3141
Practice Address - Country:US
Practice Address - Phone:651-222-7768
Practice Address - Fax:651-698-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty