Most Relevant Information
Provider Data
| NPI Number: | 1003207564 |
| Provider Name: | AZMINA VINING CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 3993-154 |
Most Important Dates
| Enumeration Date: | 02/05/2015 |
| Last Updated: | 07/07/2020 |
Provider Practice Location
6693 TIMBER RIDGE LANE CT
COTTAGE GROVE
MN
550166100
Practice Location Phone/Fax
| Phone: | 6513530634 |
| Fax: |
Provider Mailing Location
6693 TIMBER RIDGE LANE CT
COTTAGE GROVE
MN
550166100
Provider Mailing Phone/Fax
| Phone: | 6513530634 |
| Fax: |