Individual
ELIZABETH ELAINE MACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15600 36TH AVE N STE 120, PLYMOUTH, MN 55446-3687
(763) 595-0812
(763) 595-0824
Mailing address
15600 36TH AVE N STE 120, PLYMOUTH, MN 55446-3687
(763) 595-0812
(763) 595-0824
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
528896
MN
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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