Individual
MRS. ELIZABETH C TICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC/SLP
Contact information
Practice address
900 WEST 94TH ST, BLOOMINGTON, MN 55420
(952) 885-0418
(952) 885-0173
Mailing address
1322 ALTON ST #212, ST PAUL, MN 55116
(651) 247-5966
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8021
MN
Other
Enumeration date
09/27/2006
Last updated
11/19/2010
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