Provider Demographics
NPI:1528741576
Name:CHAPMAN, SALLY JEAN
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:JEAN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 CEDAR GROVE PKWY APT 437
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1489
Mailing Address - Country:US
Mailing Address - Phone:651-245-2486
Mailing Address - Fax:
Practice Address - Street 1:3903 CEDAR GROVE PKWY APT 437
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1489
Practice Address - Country:US
Practice Address - Phone:651-245-2486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN317693235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist