Most Relevant Information
Provider Data
| NPI Number: | 1003209081 |
| Provider Name: | KRYSTLE SHANE SMITH SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 8348 |
Most Important Dates
| Enumeration Date: | 03/14/2015 |
| Last Updated: | 03/14/2015 |
Provider Practice Location
1350 SAINT PETER ST
DELANO
MN
553282837
Practice Location Phone/Fax
| Phone: | 7636880353 |
| Fax: |
Provider Mailing Location
15127 81ST ST NE
OTSEGO
MN
553304558
Provider Mailing Phone/Fax
| Phone: | 7636880353 |
| Fax: |