Individual
LISA MARIE RICKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
3111 124TH AVE NW STE 123, COON RAPIDS, MN 55433-4573
(763) 236-7337
Mailing address
11604 65TH AVE N, MAPLE GROVE, MN 55369-6100
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8381
MN
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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