Individual
STACY IZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7250 FRANCE AVE S, SUITE 305, EDINA, MN 55435-4305
(952) 285-2840
Mailing address
17747 BALLANTRAE CIR, EDEN PRAIRIE, MN 55347-3435
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8737
MN
Other
Enumeration date
06/10/2011
Last updated
06/10/2011
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