CARRIE LATVALA JERYLO (NPI# 1770629297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770629297 |
| Entity Type | Individual |
| Full Name | CARRIE LATVALA JERYLO |
| Other Name | CARRIE JEAN LATVALA |
| Credential | M.S., CCC-SLP |
| Practice Address |
13750 Crosstown Dr Nw Suite 310 Andover MN 55304-5853 |
| Mailing Address |
14060 Aztec St Nw Andover MN 55304-7443 |
| Practice Telephone | 7637554275 |
| Practice Fax Number | 7637554261 |
| Mailing Telephone | 7634221392 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 6292 | MN | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUECROSSBLUESHIELD | 131G3JE | 01 |
| MN | HEALTHPARTNERS | HP34823 | 01 |
| MN | MEDICA | 46-00854 | 01 |
| Street Address |
13750 CROSSTOWN DR NW SUITE 310 |
| City | ANDOVER |
| State | MN |
| Zip Code | 55304-5853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255337408 | Wayne Edward Pratt | Chiropractor | 13750 Crosstown Dr Nw, Suite L102, Andover, MN 55304-5853 | 2005-06-22 |
| 1043662414 | Gary Scott Howard | Counselor | 13750 Crosstown Dr Nw, Molly Professional Center,phase II #207, Andover, MN 55304-5853 | 2016-07-08 |
| 1760841662 | Bennett Jones | Social Worker | 13750 Crosstown Dr Nw, Molly Professional Center, Phase II, #207, Andover, MN 55304-5853 | 2016-02-19 |
| 1245561711 | Susan C Wasilk | Social Worker | 13750 Crosstown Dr Nw, Suite 106, Andover, MN 55304-5853 | 2010-01-23 |
| 1770731739 | Pamela Ann Robsahm | Specialist | 13750 Crosstown Dr Nw, Suite L100, Andover, MN 55304-5853 | 2008-09-03 |
| 1356515290 | Cheryl Lynne Olmsted | Massage Therapist | 13750 Crosstown Dr Nw, Suite L100, Andover, MN 55304-5853 | 2008-04-22 |
| 1881886570 | Jennie Marie Graff-dolezal | Marriage & Family Therapist | 13750 Crosstown Dr Nw, Suite 102, Andover, MN 55304-5853 | 2007-08-16 |
| 1538370820 | Benjamin J Wolf | Social Worker | 13750 Crosstown Dr Nw, Suite L101, Andover, MN 55304-5853 | 2007-05-25 |
| 1487786018 | Lynn M. Swanson | Occupational Therapist | 13750 Crosstown Dr Nw, Andover, MN 55304-5853 | 2007-03-09 |
| 1013063213 | Melissa Sue Lonsky | Speech-Language Pathologist | 13750 Crosstown Dr Nw, Andover, MN 55304-5853 | 2007-01-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114402211 | Sarah Sue Anderson | Speech-Language Pathologist | 1891 Station Pkwy, Andover, MN 55304 | 2018-09-25 |
| 1306354329 | Jennifer Lynn Larkey I | Counselor | 1875 Station Parkway N.w. Andover, Mn 55304, Andover, MN 55304 | 2018-01-11 |
| 1124544895 | Msp Dentistry Inc | Preferred Provider Organization | 13650 Hanson Blvd., Suite #110, Andover, MN 55304 | 2017-08-15 |
| 1912427931 | Brooke Nicole Halliday | Counselor | 1875 Station Pkwy Ne, Andover, MN 55304 | 2017-06-21 |
| 1700286903 | Jari Welle, Inc. | Marriage & Family Therapist | 1328 Mckay Drive Ne, Suite 100, Ham Lake, MN 55304 | 2014-08-26 |
| 1356765192 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 1889 139th Ave Nw, Andover, MN 55304 | 2014-02-14 |
| 1326462177 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 1899 139th Ave Nw, Andover, MN 55304 | 2014-02-14 |
| 1740619568 | Delores Weikle | Physical Therapist | 14531 Jay St, Andover, MN 55304 | 2013-11-02 |
| 1730527003 | Darkou Care Services | Home Health | 14297 Zilla Street Nw, Andover, MN 55304 | 2013-06-10 |
| 1770927758 | Arbor Oaks Senior Living | Assisted Living Facility | 1640 155th Lane Nw, Andover, MN 55304 | 2013-04-22 |
| Find all providers in zip 55304 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386119956 | Bethann Deleo | Speech-Language Pathologist | 18 Wabanaki Way, Andover, MA 01810-5513 | 2018-10-09 |
| 1114402211 | Sarah Sue Anderson | Speech-Language Pathologist | 1891 Station Pkwy, Andover, MN 55304 | 2018-09-25 |
| 1083100549 | Chelsea Burdick | Speech-Language Pathologist | 4252 County Road 12, Andover, NY 14806 | 2018-07-09 |
| 1770941106 | Sofia Mourmoutis | Speech-Language Pathologist | 1 Archer Ln, Andover, MA 01810-5701 | 2016-01-30 |
| 1659629145 | Margot E Kelman | Speech-Language Pathologist | 123 S Putter Dr, Andover, KS 67002-8823 | 2012-08-15 |
| 1679876528 | Nora H Jassak | Speech-Language Pathologist | 260 Fisher Rd, Andover, NY 14806-9626 | 2010-12-15 |
| 1740437276 | Jennifer Austin Smith | Speech-Language Pathologist | 3135 Elm Street, Andover, NY 14806 | 2008-08-27 |
| 1568623742 | Nicole Marie Fritzky | Speech-Language Pathologist | 32 Crescent Dr S, Andover, NJ 07821-4006 | 2008-06-20 |
| 1679788707 | Audrey S. Rubin | Speech-Language Pathologist | 12 Rose Glen Dr, Andover, MA 01810-4704 | 2007-05-11 |
| 1942336151 | Mary T Behl | Speech-Language Pathologist | 44 Park St, 3rd Floor, Andover, MA 01810-3692 | 2007-02-24 |
| Find all providers in ANDOVER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.