Provider Demographics
NPI:1932155413
Name:NAGGATZ, KAY LYNN (MS,CCC-A)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:LYNN
Last Name:NAGGATZ
Suffix:
Gender:F
Credentials:MS,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39472 HOMESTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BRANCH
Mailing Address - State:MN
Mailing Address - Zip Code:55056-5341
Mailing Address - Country:US
Mailing Address - Phone:651-674-8709
Mailing Address - Fax:
Practice Address - Street 1:6525 FRANCE AVE S
Practice Address - Street 2:SUITE 325
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2148
Practice Address - Country:US
Practice Address - Phone:952-920-4595
Practice Address - Fax:952-920-7958
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5334231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist