Provider Demographics
NPI:1255522769
Name:KIRCHOFF, JAMIE K (AUD, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:K
Last Name:KIRCHOFF
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 WOODWINDS DR
Mailing Address - Street 2:SUITE #240
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2523
Mailing Address - Country:US
Mailing Address - Phone:651-702-0750
Mailing Address - Fax:651-645-6166
Practice Address - Street 1:1675 BEAM AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1172
Practice Address - Country:US
Practice Address - Phone:651-770-1105
Practice Address - Fax:651-770-1226
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8229231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist