| Ciera Renee Bacon, | |
|
15590 90th St Ne, Otsego, MN 55330-9452 | |
| (763) 755-4275 | |
| Not Available |
| Full Name | Ciera Renee Bacon |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 15590 90th St Ne, Otsego, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437723897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
| Provider Name | Family Speech & Therapy Services LLC |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1235285966 PECOS PAC ID: 8022335397 Enrollment ID: O20150325001650 |
| Mailing Address | Practice Location Address |
|---|---|
| Ciera Renee Bacon, 15590 90th St Ne, Otsego, MN 55330-9452 Ph: (763) 755-4275 | Ciera Renee Bacon, 15590 90th St Ne, Otsego, MN 55330-9452 Ph: (763) 755-4275 |
Ali Karels, Speech-Language Pathologist Medicare: May Accept Medicare Assignments Practice Location: 15590 90th St Ne, Otsego, MN 55330 Phone: 763-308-3869 |
Nicole Martinson, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 15555 73rd St Ne, Otsego, MN 55330 Phone: 763-245-6591 |
Page Holst, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 15590 90th St Ne, Otsego, MN 55330 Phone: 763-755-4275 Fax: 763-755-4261 |
Laura Stevenson, M.S., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 15990 90th St., Otsego, MN 55330 Phone: 763-755-4275 |
Jolene Marie Carlson Law, M.S., CF-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 15590 90th St Ne, Otsego, MN 55330 Phone: 763-755-4275 Fax: 763-755-4261 |
Kelly C Gorder, MS, SLP-CCC Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 16940 56th Ct Ne, Otsego, MN 55374 Phone: 763-300-1862 |
Lauren Michelle Frank, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 15590 90th St Ne, Otsego, MN 55330 Phone: 763-308-3869 |