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Individual

RACHAEL MARY LOOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S, CCC-SLP

Contact information

Practice address
12400 PORTLAND AVE STE 140, BURNSVILLE, MN 55337-6805
(952) 428-0400
Mailing address
12400 PORTLAND AVE STE 140, BURNSVILLE, MN 55337-6805
(952) 428-0400

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
518226
MN
235Z00000X
Speech-Language Pathologist
5245
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
518226
MN STATE LICENSE NUMBER
MN
Enumeration date
06/07/2021
Last updated
06/20/2022
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