Provider Demographics
NPI:1376697441
Name:FROST, SHEILA MARIE (MST, CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:MARIE
Last Name:FROST
Suffix:
Gender:F
Credentials:MST, CCC SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3800 PARK NICOLLET BLVD
Mailing Address - Street 2:SPEECH DEPARTMENT
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2527
Mailing Address - Country:US
Mailing Address - Phone:952-993-3036
Mailing Address - Fax:952-993-1250
Practice Address - Street 1:3800 PARK NICOLLET BLVD
Practice Address - Street 2:SPEECH DEPARTMENT
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2527
Practice Address - Country:US
Practice Address - Phone:952-993-3036
Practice Address - Fax:952-993-1250
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN7362235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN7362OtherMN DEPARTMENT OF HEALTH
MN01093855OtherASHA