Lisa A Wicktor, MA CCC SLP
NPI #1104049162 in Minneapolis, Minnesota
Provider Information
- NPI Number
- 1104049162
- Entity Type
- Individual
- Name
- Lisa A Wicktor, MA CCC SLP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Speech-Language Pathologist
- Credential
- MA CCC SLP
- Enumeration Date
- Apr 10, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 701 PARK AVE
- City
- Minneapolis
- State
- Minnesota
- ZIP Code
- 55415-1623
- Phone
- (612) 873-3899
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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