| Tina Fausett, MS, CCC-SLP | |
|
11455 Viking Dr, Suite 300, Eden Prairie, MN 55344-7251 | |
| (952) 993-2498 | |
| (952) 993-2505 |
| Full Name | Tina Fausett |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 11455 Viking Dr, Eden Prairie, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871721514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 7620 (Minnesota) | Primary |
| Provider Name | Park Nicollet Clinic |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
| Mailing Address | Practice Location Address |
|---|---|
| Tina Fausett, MS, CCC-SLP 11455 Viking Dr, Suite 300, Eden Prairie, MN 55344-7251 Ph: () - | Tina Fausett, MS, CCC-SLP 11455 Viking Dr, Suite 300, Eden Prairie, MN 55344-7251 Ph: (952) 993-2498 |
Jennifer Dorothy Miller, MS CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 7624 Executive Dr, Eden Prairie, MN 55344 Phone: 952-944-0240 Fax: 952-944-0241 | |
Natasha Agha, CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 8307 Kimball Dr, Eden Prairie, MN 55347 Phone: 612-324-9111 Fax: 612-445-9223 | |
Ms. Margaret Elizabeth Dvergsten-kitzrow, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6542 Kingfisher Ln, Eden Prairie, MN 55346 Phone: 712-291-6721 | |
Mackenzie Wood, CCC, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6458 City West Pkwy, Eden Prairie, MN 55344 Phone: 952-767-6977 | |
Kendra Vander Linden, MA, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 7570 Market Place Dr, Eden Prairie, MN 55344 Phone: 952-944-0240 | |
Anna Gavin, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6409 City West Pkwy Ste 206, Eden Prairie, MN 55344 Phone: 952-230-8173 | |
Isabel R St Dennis, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6409 City West Pkwy Ste 206, Eden Prairie, MN 55344 Phone: 952-500-8871 Fax: 612-778-1588 |