Provider Demographics
NPI:1194259655
Name:SPERL, MARIA JUDE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:JUDE
Last Name:SPERL
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 1:867 JUNO AVE
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-3713
Mailing Address - Country:US
Mailing Address - Phone:612-236-6183
Mailing Address - Fax:
Practice Address - Street 1:867 JUNO AVE
Practice Address - Street 2:APARTMENT 2
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-3713
Practice Address - Country:US
Practice Address - Phone:612-236-6183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN14077177235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist