Individual
MS. ELINA KOTLYAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3395 PLYMOUTH RD, MINNETONKA, MN 55305
(952) 939-0396
Mailing address
3395 PLYMOUTH RD, MINNETONKA, MN 55305-3765
(952) 939-0396
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP5154
SLP LICENSE
MA
Enumeration date
01/13/2006
Last updated
07/21/2022
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