LISA A WICKTOR

MINNEAPOLIS, MN
NPI1104049162
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: MN  5691)
Enumeration Date2007-04-10
Last Update Date2007-07-08
Business Address
-- LISA A WICKTOR MA CCC SLP
701 PARK AVE
MINNEAPOLIS, MN 55415-1623
Phone number: 612-873-3899
Mailing Address
-- LISA A WICKTOR MA CCC SLP
701 PARK AVE
MINNEAPOLIS, MN 55415-1623
Phone number: 612-873-6005
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