Provider Demographics
NPI:1407284375
Name:SANDOR, KYLIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:KYLIE
Middle Name:
Last Name:SANDOR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KYLIE
Other - Middle Name:
Other - Last Name:HODGEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5565 BLAINE AVE
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-1238
Mailing Address - Country:US
Mailing Address - Phone:651-888-7800
Mailing Address - Fax:651-888-7801
Practice Address - Street 1:5565 BLAINE AVE
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-1238
Practice Address - Country:US
Practice Address - Phone:651-888-7800
Practice Address - Fax:651-888-7801
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9107231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist