Individual provider · Type 1 NPI

Katherine Widestrom

Speech-Language Pathologist · Champlin, MN

NPI number 1699776252 Active

Practice location

6025 109th Ave N
Champlin, MN 55316-3475

Specialties and licenses

TaxonomyCodeLicense
Speech-Language Pathologist Primary 235Z00000X7196 (MN)

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, resonan…

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About NPI 1699776252

Katherine Widestrom's National Provider Identifier is 1699776252, issued on Aug 4, 2005. The primary taxonomy on file is Speech-Language Pathologist (235Z00000X), and the practice location is in Champlin, MN. The record was last updated on May 7, 2026.