Provider Demographics
NPI:1598908543
Name:HAEN-SAWREY, AMY C (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:HAEN-SAWREY
Suffix:
Gender:F
Credentials:MS, 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:BRIDGES MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:201 9TH STREET WEST
Mailing Address - State:MN
Mailing Address - Zip Code:56510
Mailing Address - Country:US
Mailing Address - Phone:218-784-5253
Mailing Address - Fax:218-784-3753
Practice Address - Street 1:BRIDGES MEDICAL CENTER
Practice Address - Street 2:201 9TH STREET WEST
Practice Address - City:ADA
Practice Address - State:MN
Practice Address - Zip Code:56510
Practice Address - Country:US
Practice Address - Phone:218-784-5253
Practice Address - Fax:218-784-3753
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6247235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01081390OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION CERTIFICATION
ND577OtherNORTH DAKOTA STATE BOARD OF EXAMINERS CERTIFICATION FOR SPEECH-LANGUAGE PATHOLOG
MN6247OtherSTATE OF MINNESOTA, SPEECH-LANGUAGE PATHOLOGIST LICENSE NO.