Individual
SUSANNA RITACCA FISHLOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
535 LAKE SUMMIT CT, SHOREVIEW, MN 55126-4010
(954) 707-0829
Mailing address
535 LAKE SUMMIT CT, SHOREVIEW, MN 55126-4010
(612) 368-7474
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10285
MN
Other
Enumeration date
04/03/2020
Last updated
06/23/2020
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