Andrea Rose Wilson, CCC-SLP/AUD
NPI 1174183594ActiveIndividual· Speech-Language Pathologist· Fosston, MN
Speech-Language Pathologist (CCC-SLP/AUD) in Fosston, Minnesota, trained at University of Minnesota Medical School (class of 2019). Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1174183594 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CCC-SLP/AUD |
| Sole proprietor | No |
| NPI issued | Jun 18, 2019 |
| Last updated in NPPES | Nov 13, 2025 |
| Certified by provider | Nov 13, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 529087 | MN |
| Audiologist | 231H00000X | 529087 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (MN) |
|---|
Education and affiliations
| Medical school | University of Minnesota Medical School |
|---|---|
| Graduation year | 2019 |
| Medicare specialty | Qualified Speech Language Pathologist |
Medical group
- Pine Peak Therapy LLCFosston, MN · 4 clinicians
Other Speech-Language Pathologist providers in Fosston
- 1215006424
- 1023940129