IndividualActive
Mary Hagen, MA/CCC SLP
NPI 1629014378 · Speech-Language Pathologist · Plymouth, MN
Provider details
- NPI number
- 1629014378
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Credential
- MA/CCC SLP
- Sex
- Female
- Sole proprietor
- Yes
- License
- 5043 (MN)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5480 Nathan Ln N
Suite 140
Plymouth, MN 55442-1997
Phone: (763) 607-4440
Fax: (763) 553-2933
Street-level locationGet directions
Mailing address
10715 39th Ave N
Plymouth, MN 55441-1412
Registry dates
- Enumerated
- 2006-06-21
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.