Individual
GRETA FISKUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
500 PARK ST E, ANNANDALE, MN 55302-3060
(320) 274-3432
Mailing address
7991 MEADOWOOD DR, ROCKFORD, MN 55373-2104
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5917
MN
Other
Enumeration date
11/01/2013
Last updated
11/01/2013
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