Individual
MS. LISA CAROL BECKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
6500 EXCELSIOR BLVD, REHAB SERVICES - SPEECH PATHOLOGY, ST LOUIS PARK, MN 55426-4702
(952) 993-5498
(952) 993-5585
Mailing address
5641 ADAIR AVE N, CRYSTAL, MN 55429-2706
(952) 993-5498
(952) 993-5585
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5642
MN
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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