Provider Demographics
NPI:1326266842
Name:KESSLER SPEECH THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:KESSLER SPEECH THERAPY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:JODELL
Authorized Official - Middle Name:
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-251-5590
Mailing Address - Street 1:PO BOX 5123
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56302-5123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2835 W SAINT GERMAIN ST
Practice Address - Street 2:#300
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-6280
Practice Address - Country:US
Practice Address - Phone:320-215-5590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-22
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5520235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4600206OtherMEDICA
MN7985172OtherAETNA
MN4600206OtherSELECT CARE
MN7005573OtherPREFERRED ONE COMM HEALTH
MN1880044OtherMAYO MANAGEMENT
MN1A510KEOtherBLUE CROSS BLUE SHIELD
MN1A510KEOtherBLUE PLUS
MN645133OtherPRO NET
MN9390635OtherLUMENOS
MN01016518OtherPREFERRED ONE
MN115484OtherUCARE
MN7005573OtherPREFERRED ONE ADMIN SERV
MN1A510KEOtherBLUE LINK
MN1A510KEOtherBLUE CROSS BLUE SHIELD
MN1A510KEOtherBLUE LINK