Individual
LISABETH HOUSTON MACKALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1000 LOVELL AVE W, ROSEVILLE, MN 55113-4419
(612) 437-0213
Mailing address
1000 LOVELL AVE W, ROSEVILLE, MN 55113-4419
(612) 437-0213
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7658
MN
Other
Enumeration date
03/12/2008
Last updated
03/12/2008
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