Individual
PAMELA LACKRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
15265 MINNETONKA BLVD, MINNETONKA, MN 55345-1510
(952) 223-2506
Mailing address
3543 26TH AVE S, MINNEAPOLIS, MN 55406-2541
(509) 844-3536
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9335
MN
Other
Enumeration date
10/13/2015
Last updated
05/08/2020
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