Provider Demographics
NPI:1982271235
Name:ADELMAN, BREANNA (SLP)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:
Last Name:ADELMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 TURNING LEAF LN SW STE 3
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-4681
Mailing Address - Country:US
Mailing Address - Phone:320-200-2577
Mailing Address - Fax:
Practice Address - Street 1:1920 TURNING LEAF LN SW STE 3
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-4681
Practice Address - Country:US
Practice Address - Phone:320-200-2577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN518148235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist