Most Relevant Information
Provider Data
| NPI Number: | 1003250861 |
| Provider Name: | LINDA JEANNE MIX YATES SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 201829 |
Most Important Dates
| Enumeration Date: | 04/24/2013 |
| Last Updated: | 07/17/2024 |
Provider Practice Location
6545 FLYING CLOUD DR STE 201
EDEN PRAIRIE
MN
553443356
Practice Location Phone/Fax
| Phone: | 6123641901 |
| Fax: |
Provider Mailing Location
7900 W 28TH ST
ST LOUIS PARK
MN
554263011
Provider Mailing Phone/Fax
| Phone: | 9529208380 |
| Fax: | 9529208764 |