| Advance Therapy | |
|
6776 Lake Dr, 220, Lino Lakes, MN 55014 | |
| (651) 784-7007 | |
| (651) 784-7992 |
| Full Name | Advance Therapy |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 6776 Lake Dr, Lino Lakes, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215144654 | NPI | - | NPPES |
| 073222200 | Medicaid | MN |
| Provider Name | Jennifer M Jensen |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1386613412 PECOS PAC ID: 0446569693 Enrollment ID: I20151029000474 |
| Provider Name | Sarah E Williams |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1790943611 PECOS PAC ID: 4183933344 Enrollment ID: I20151029000731 |
| Provider Name | Kaylen A Whetstone |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1104089929 PECOS PAC ID: 0749581072 Enrollment ID: I20151210001742 |
| Provider Name | Jessica D Vietor |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1932656691 PECOS PAC ID: 3375827769 Enrollment ID: I20170302001940 |
| Provider Name | Anna K Pfau Clark |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1841747508 PECOS PAC ID: 9335423722 Enrollment ID: I20170302002108 |
| Provider Name | Angie M Thompson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1376153346 PECOS PAC ID: 4981024221 Enrollment ID: I20201026002207 |
| Provider Name | Hannah R Coskran |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427555192 PECOS PAC ID: 0547662991 Enrollment ID: I20210708001167 |
| Provider Name | Bailey J Reiner |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1679245658 PECOS PAC ID: 4981081247 Enrollment ID: I20220507000220 |
| Provider Name | Kate O Hanson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1588309561 PECOS PAC ID: 3577943307 Enrollment ID: I20220711000849 |
| Provider Name | Renee D Bouchareb |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1215612189 PECOS PAC ID: 8426419862 Enrollment ID: I20230801002165 |
| Provider Name | Kaelyn Layell Isaacson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1144010448 PECOS PAC ID: 1052825528 Enrollment ID: I20250708000984 |
| Provider Name | Jungwoo Roh |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1588311781 PECOS PAC ID: 8022597210 Enrollment ID: I20260209001233 |
| Provider Name | Louisa Warren |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1235089707 PECOS PAC ID: 3870074198 Enrollment ID: I20260225001914 |
| Mailing Address | Practice Location Address |
|---|---|
| Advance Therapy 6776 Lake Dr, 220, Lino Lakes, MN 55014-1191 Ph: (651) 784-7007 | Advance Therapy 6776 Lake Dr, 220, Lino Lakes, MN 55014 Ph: (651) 784-7007 |
Emily Goldhammer, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6776 Lake Dr, 220, Lino Lakes, MN 55014 Phone: 651-784-7007 Fax: 651-784-7992 |
Advance Therapy Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6776 Lake Dr, Lino Lakes, MN 55014 Phone: 651-784-7007 |
Shana Banas, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6776 Lake Dr, 220, Lino Lakes, MN 55014 Phone: 651-784-7007 |
Kaylen Whetstone, CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 6776 Lake Dr, 220, Lino Lakes, MN 55014 Phone: 651-784-7007 Fax: 651-784-7992 |
Kaelyn Layell Isaacson, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 6776 Lake Dr Ste 220, Lino Lakes, MN 55014 Phone: 651-784-7007 |
Renee Deborah Therrien Bouchareb, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 6776 Lake Dr Ste 220, Lino Lakes, MN 55014 Phone: 651-784-7007 |
Ms. Judith Christensen Gelderman, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6776 Lake Dr, 220, Lino Lakes, MN 55014 Phone: 651-784-7007 Fax: 651-784-7992 |