| Sora Pediatric Therapy | |
|
1891 Station Pkwy Nw, Andover, MN 55304 | |
| (763) 755-4275 | |
| (763) 755-4261 |
| Full Name | Sora Pediatric Therapy |
|---|---|
| Type | Facility |
| Speciality | Speech-language Pathologist |
| Location | 1891 Station Pkwy Nw, Andover, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235285966 | NPI | - | NPPES |
| 01043879 | Other | MN | PREFERRED ONE |
| 150165800 | Medicaid | MN | |
| 73G75FA | Other | MN | BLUE CROSS BLUE SHIELD |
| 99915 | Other | MN | HEALTHPARTNERS |
| Provider Name | Kristin L Connell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336244375 PECOS PAC ID: 7113923434 Enrollment ID: I20061010000529 |
| Provider Name | Pamela S Lundequam |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063598605 PECOS PAC ID: 8527068238 Enrollment ID: I20070103000219 |
| Provider Name | Katherine I Wacker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720285638 PECOS PAC ID: 3971699745 Enrollment ID: I20071010000341 |
| Provider Name | Andria Marie Davis |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487043865 PECOS PAC ID: 2567789522 Enrollment ID: I20150331002902 |
| Provider Name | Melissa S Lonsky |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1013063213 PECOS PAC ID: 0446577720 Enrollment ID: I20150417000906 |
| Provider Name | Emily J Jung |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1447532494 PECOS PAC ID: 4183938509 Enrollment ID: I20150729009552 |
| Provider Name | Molly M Nordberg |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1508275207 PECOS PAC ID: 5597079913 Enrollment ID: I20150729009704 |
| Provider Name | Alicia J Marten |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841414794 PECOS PAC ID: 4981918208 Enrollment ID: I20150730013539 |
| Provider Name | Kelly L Hungaski |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1235357898 PECOS PAC ID: 9234273863 Enrollment ID: I20150730013822 |
| Provider Name | Sarah S Biers |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154313161 PECOS PAC ID: 1355655507 Enrollment ID: I20150731014785 |
| Provider Name | Carrie L Jerylo |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1770629297 PECOS PAC ID: 9830404961 Enrollment ID: I20150818004918 |
| Provider Name | Jessica L Naiberg |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215208939 PECOS PAC ID: 9032410006 Enrollment ID: I20151216000876 |
| Provider Name | Sarah N Zinkel |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437335643 PECOS PAC ID: 7416258942 Enrollment ID: I20151229000262 |
| Provider Name | Jennifer A Schwalbach |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932463379 PECOS PAC ID: 3971805052 Enrollment ID: I20160106001615 |
| Provider Name | Kristine S Vogtlin |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1558816470 PECOS PAC ID: 9032406525 Enrollment ID: I20160927002347 |
| Provider Name | Laura M Bollig |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144778044 PECOS PAC ID: 7012298540 Enrollment ID: I20161221001176 |
| Provider Name | Leeann Rae Kyriakides |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1285681247 PECOS PAC ID: 0143503946 Enrollment ID: I20170201001092 |
| Provider Name | Deborah L Gabel |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164949178 PECOS PAC ID: 9537435680 Enrollment ID: I20171018000823 |
| Provider Name | Kathryn E Perovich |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871012815 PECOS PAC ID: 1355617333 Enrollment ID: I20171018001913 |
| Provider Name | Saige Baker-lietz |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417460809 PECOS PAC ID: 8022376490 Enrollment ID: I20171213002464 |
| Provider Name | Sara Jesse Gleason |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457871956 PECOS PAC ID: 5597023721 Enrollment ID: I20171218001079 |
| Provider Name | Anne Catherine Mugaas |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1982103289 PECOS PAC ID: 7012279748 Enrollment ID: I20180316001886 |
| Provider Name | Courtney Lyn Sanocki |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1497299499 PECOS PAC ID: 6608130596 Enrollment ID: I20180430002422 |
| Provider Name | Kaylin Horne |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1134631682 PECOS PAC ID: 9638428584 Enrollment ID: I20180827000046 |
| Provider Name | Ellen Johnson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073096608 PECOS PAC ID: 9234481375 Enrollment ID: I20181017003177 |
| Provider Name | Maria Faye Davis |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760984181 PECOS PAC ID: 3173875242 Enrollment ID: I20181018000502 |
| Provider Name | Kerri Mulder |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1245718535 PECOS PAC ID: 1850645177 Enrollment ID: I20181126001261 |
| Provider Name | Bryden Giving |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144794413 PECOS PAC ID: 0648510693 Enrollment ID: I20190329000111 |
| Provider Name | Nicole Rechtzigel |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1558921064 PECOS PAC ID: 8022340413 Enrollment ID: I20191105000923 |
| Provider Name | Michelle A Deremer |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1326697756 PECOS PAC ID: 5395177919 Enrollment ID: I20191119002365 |
| Provider Name | Laura L Jaeger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326684556 PECOS PAC ID: 7810321965 Enrollment ID: I20191223001720 |
| Provider Name | Raina Demarais |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700416914 PECOS PAC ID: 3173953684 Enrollment ID: I20200424001332 |
| Provider Name | Lindsey Hove |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932732179 PECOS PAC ID: 0749610194 Enrollment ID: I20200427000000 |
| Provider Name | Alissa Deardorff |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528693785 PECOS PAC ID: 4082045745 Enrollment ID: I20200513000027 |
| Provider Name | Jaidyn Johnson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376178442 PECOS PAC ID: 8022449750 Enrollment ID: I20200513003241 |
| Provider Name | Amy Brisson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1235741604 PECOS PAC ID: 3870910102 Enrollment ID: I20200901000524 |
| Provider Name | Alexi Mercedes Leclaire |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679129795 PECOS PAC ID: 9638400534 Enrollment ID: I20200901000931 |
| Provider Name | Stephanie Frey |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1992353882 PECOS PAC ID: 8729405972 Enrollment ID: I20200902001008 |
| Provider Name | Elsie Mcclelland |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518592625 PECOS PAC ID: 6507285947 Enrollment ID: I20201002002715 |
| Provider Name | Andrea Christ |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1780285072 PECOS PAC ID: 9739592395 Enrollment ID: I20201229001121 |
| Provider Name | Lindsey Koosman |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1710535604 PECOS PAC ID: 0941614523 Enrollment ID: I20210121001814 |
| Provider Name | Paige Melby |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417550898 PECOS PAC ID: 3678988342 Enrollment ID: I20210211001123 |
| Provider Name | Shelly Sontag-johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164018263 PECOS PAC ID: 5193130391 Enrollment ID: I20210222001577 |
| Provider Name | Victoria Shear |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1710589023 PECOS PAC ID: 2466867304 Enrollment ID: I20210226000971 |
| Provider Name | Abby Rose Kargul |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427679992 PECOS PAC ID: 4385050335 Enrollment ID: I20210317000784 |
| Provider Name | Taylor M Grootwassink |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811572936 PECOS PAC ID: 5890103972 Enrollment ID: I20210412000225 |
| Provider Name | Ellen Stowe |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1205411428 PECOS PAC ID: 0840609541 Enrollment ID: I20210510002514 |
| Provider Name | Melody Koerselman |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346828548 PECOS PAC ID: 8426467135 Enrollment ID: I20210511000266 |
| Provider Name | Mariel Leigh Goettsch |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902158132 PECOS PAC ID: 8325457963 Enrollment ID: I20210511001540 |
| Provider Name | Brittany Wickoren |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1215515424 PECOS PAC ID: 0042619280 Enrollment ID: I20210520001622 |
| Provider Name | Kathryn Rubinchik |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1669734638 PECOS PAC ID: 1759689805 Enrollment ID: I20210707000905 |
| Provider Name | Alyssa Besch |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972117463 PECOS PAC ID: 7911301718 Enrollment ID: I20210802000388 |
| Provider Name | Andrea Zeng |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1386216711 PECOS PAC ID: 0244634830 Enrollment ID: I20210804000701 |
| Provider Name | Natalie J Frier |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1205397726 PECOS PAC ID: 6507260890 Enrollment ID: I20210809002906 |
| Provider Name | Nicole Marie Chisholm |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013592542 PECOS PAC ID: 2961810510 Enrollment ID: I20210809003052 |
| Provider Name | Courtney Wagner |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1023680451 PECOS PAC ID: 3870997018 Enrollment ID: I20210810001294 |
| Provider Name | Kimberlee B Gross |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1164701074 PECOS PAC ID: 6002212842 Enrollment ID: I20210902002189 |
| Provider Name | Roxana Isabel Chirinos |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1366119638 PECOS PAC ID: 4789081951 Enrollment ID: I20210930002371 |
| Provider Name | Molly O'donnell Nicolai |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1609206119 PECOS PAC ID: 2668860636 Enrollment ID: I20211025000265 |
| Provider Name | Ashely Ka Zoua Xiong |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487318572 PECOS PAC ID: 9234527847 Enrollment ID: I20211102000285 |
| Provider Name | Sydney M Brock |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508354325 PECOS PAC ID: 2668863259 Enrollment ID: I20211215000364 |
| Provider Name | Carlene Osweiler |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1558027284 PECOS PAC ID: 4082006085 Enrollment ID: I20220125002889 |
| Provider Name | Sarah Sneltjes |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770249401 PECOS PAC ID: 5991198210 Enrollment ID: I20220209002762 |
| Provider Name | Morgan Evitts |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669138384 PECOS PAC ID: 8628462587 Enrollment ID: I20220218002169 |
| Provider Name | Madecyn Caroline Franz |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1700495587 PECOS PAC ID: 9335534098 Enrollment ID: I20220315001867 |
| Provider Name | Jennifer Anne Jordan |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1851617575 PECOS PAC ID: 3577959568 Enrollment ID: I20220330002285 |
| Provider Name | Evelyn L Mueggenberg |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649913468 PECOS PAC ID: 6709264104 Enrollment ID: I20220525001505 |
| Provider Name | Lucy M Zeihen |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770226441 PECOS PAC ID: 7012395411 Enrollment ID: I20220525001674 |
| Provider Name | Amber Bauer |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255097986 PECOS PAC ID: 5597143909 Enrollment ID: I20220525001974 |
| Provider Name | Kendra Mertes |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750033593 PECOS PAC ID: 8224416516 Enrollment ID: I20220526002643 |
| Provider Name | Morgan Marie Voss |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699224923 PECOS PAC ID: 0941688238 Enrollment ID: I20220526002672 |
| Provider Name | Kiley Hogg |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1245723105 PECOS PAC ID: 7911385208 Enrollment ID: I20220526002761 |
| Provider Name | Autumn Dose |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356074140 PECOS PAC ID: 8729463310 Enrollment ID: I20220919000510 |
| Provider Name | Molly Pybas |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1578296372 PECOS PAC ID: 8921483546 Enrollment ID: I20220919001765 |
| Provider Name | Emelia Miner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548988900 PECOS PAC ID: 9335524966 Enrollment ID: I20220919002082 |
| Provider Name | Taylor Freese |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1497488209 PECOS PAC ID: 2860877495 Enrollment ID: I20220919002192 |
| Provider Name | Allyson Hansen Rogers |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1649903444 PECOS PAC ID: 4688059215 Enrollment ID: I20220919002198 |
| Provider Name | Kallie Medenwald |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1649903451 PECOS PAC ID: 2668857194 Enrollment ID: I20220919002665 |
| Provider Name | Kaley Rae Anderson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1780233536 PECOS PAC ID: 8729463252 Enrollment ID: I20220919002739 |
| Provider Name | Stephanie Olson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1568195360 PECOS PAC ID: 7810372364 Enrollment ID: I20220919003250 |
| Provider Name | Hannah Smoker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972221331 PECOS PAC ID: 8527443076 Enrollment ID: I20220919003292 |
| Provider Name | Sydney Lenz |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1699493056 PECOS PAC ID: 5890170344 Enrollment ID: I20220919003334 |
| Provider Name | Sara Dasler |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1518685973 PECOS PAC ID: 9335524834 Enrollment ID: I20220920002162 |
| Provider Name | Grace Bestler |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437877891 PECOS PAC ID: 2567847080 Enrollment ID: I20220920002906 |
| Provider Name | Ashley Stephens |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700519519 PECOS PAC ID: 6507242948 Enrollment ID: I20221007001794 |
| Provider Name | Callie Aho |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376266197 PECOS PAC ID: 2668841230 Enrollment ID: I20221205000912 |
| Provider Name | Cassandra Wald |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801225685 PECOS PAC ID: 0749650349 Enrollment ID: I20221222001789 |
| Provider Name | Alyssa Smith |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1881239143 PECOS PAC ID: 4183094790 Enrollment ID: I20221222001949 |
| Provider Name | Kristina Dose |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1033834775 PECOS PAC ID: 5890165419 Enrollment ID: I20221222002504 |
| Provider Name | Maria Miller |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437865052 PECOS PAC ID: 0648644229 Enrollment ID: I20230322000701 |
| Provider Name | Suzanne Berg |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124723416 PECOS PAC ID: 2466817614 Enrollment ID: I20230424001197 |
| Provider Name | Caitlyn Bath |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629770144 PECOS PAC ID: 4880059484 Enrollment ID: I20230504001023 |
| Provider Name | Holly Shilling |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952001208 PECOS PAC ID: 4082070214 Enrollment ID: I20230515000782 |
| Provider Name | Claire Oberle |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306405428 PECOS PAC ID: 5193181212 Enrollment ID: I20230516001878 |
| Provider Name | Jacqueline Jeziorski |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1386362747 PECOS PAC ID: 8628434594 Enrollment ID: I20230518001891 |
| Provider Name | Sadie George |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629768874 PECOS PAC ID: 4284090879 Enrollment ID: I20230524002701 |
| Provider Name | Hailey Nelson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1801529607 PECOS PAC ID: 6002272549 Enrollment ID: I20230525001323 |
| Provider Name | Montana Nelson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1306537899 PECOS PAC ID: 4284093675 Enrollment ID: I20230703001176 |
| Provider Name | Hannah Arason |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1669157202 PECOS PAC ID: 5092174896 Enrollment ID: I20230711001549 |
| Provider Name | Brittany Erickson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1174217459 PECOS PAC ID: 7911366729 Enrollment ID: I20230711001803 |
| Provider Name | Michelle Macgillivray |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1346926755 PECOS PAC ID: 6800255647 Enrollment ID: I20230711002708 |
| Provider Name | Megan Dierking |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1003591652 PECOS PAC ID: 7315307097 Enrollment ID: I20230712003985 |
| Provider Name | Jordan Enevold |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1851076202 PECOS PAC ID: 4981064565 Enrollment ID: I20230713003240 |
| Provider Name | Haley Lipscomb |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487248019 PECOS PAC ID: 6406216035 Enrollment ID: I20230714000804 |
| Provider Name | Lydia Nemeth |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1740973080 PECOS PAC ID: 6002277993 Enrollment ID: I20230725000954 |
| Provider Name | Madeline Wells |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1497449979 PECOS PAC ID: 7113388935 Enrollment ID: I20230726002401 |
| Provider Name | Ashley Sprain |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073292322 PECOS PAC ID: 9931560463 Enrollment ID: I20230801001382 |
| Provider Name | Loran Hawkins |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1245918515 PECOS PAC ID: 9133580327 Enrollment ID: I20230803004026 |
| Provider Name | Morgan Heilman |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1508543315 PECOS PAC ID: 4789047754 Enrollment ID: I20230824001836 |
| Provider Name | Alison O'sadnick |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225774060 PECOS PAC ID: 6002279486 Enrollment ID: I20230901000494 |
| Provider Name | Madeline Clubb |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447944749 PECOS PAC ID: 1254795149 Enrollment ID: I20230911003407 |
| Provider Name | Inga Rohde |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144908930 PECOS PAC ID: 2365806296 Enrollment ID: I20230912000753 |
| Provider Name | Laura Marie Jakes |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730841081 PECOS PAC ID: 4486008117 Enrollment ID: I20230928001202 |
| Provider Name | Andrea Konz |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1609653344 PECOS PAC ID: 8224482971 Enrollment ID: I20230928001895 |
| Provider Name | Sarah Mcgoldrick |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770267916 PECOS PAC ID: 2668829581 Enrollment ID: I20231114001198 |
| Provider Name | Kristine Girbe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932972445 PECOS PAC ID: 6204286826 Enrollment ID: I20231222001097 |
| Provider Name | Ellison Rose Schmillen |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912775982 PECOS PAC ID: 0042660094 Enrollment ID: I20240103001876 |
| Provider Name | Rachel Evavold |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689444234 PECOS PAC ID: 4880047661 Enrollment ID: I20240129000951 |
| Mailing Address | Practice Location Address |
|---|---|
| Sora Pediatric Therapy 1891 Station Pkwy Nw, Andover, MN 55304 Ph: (763) 755-4275 | Sora Pediatric Therapy 1891 Station Pkwy Nw, Andover, MN 55304 Ph: (763) 755-4275 |
Megan Dierking, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1891 Station Pkwy Nw, Andover, MN 55304 Phone: 763-755-4275 | |
Mrs. Melissa Sue Lonsky, CCC-SLP, OM Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 13750 Crosstown Dr Nw, Andover, MN 55304 Phone: 763-755-4275 Fax: 763-755-4261 | |
Courtney Wagner, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1891 Station Pkwy Nw, Andover, MN 55304 Phone: 763-755-4275 | |
Kristina Dose, MA, SLLP-CF/DE Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1891 Station Pkwy Nw, Andover, MN 55304 Phone: 763-755-4275 Fax: 763-755-4261 | |
Ms. Kelsey Anne Wegner, M.A., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1891 Station Pkwy Nw, Andover, MN 55304 Phone: 763-755-4275 | |
Nicole Morrissey, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1891 Station Pkwy Nw, Andover, MN 55304 Phone: 763-350-0371 | |
Kayla Braun, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1891 Station Pkwy Nw, Andover, MN 55304 Phone: 763-755-4275 |