Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jerra-Lynn Boudjouk, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1033201371

Jerra-Lynn Boudjouk, CCC-SLP is a Speech-Language Pathologist in Minneapolis, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
What do these letters mean?
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

1250 W Broadway Ave
Minneapolis, MN 55411-2533
Phone: (612) 668-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 7510 (MN)

Record details

NPI number1033201371
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorNo
NPI enumeratedSeptember 28, 2006
Last updated in NPPESDecember 10, 2025
Certification dateDecember 10, 2025
Mailing address1250 W Broadway Ave, Minneapolis, MN 55411-2533

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