Individual
ELISSA LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS SLP CCC
Contact information
Practice address
3025 HARBOR LN N, PLYMOUTH, MN 55447-5119
(612) 321-8957
Mailing address
2700 SYLVAN RD S, MINNETONKA, MN 55305-2820
(612) 600-1475
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2007019046
MO
235Z00000X
Speech-Language Pathologist
Primary
8434
MN
Other
Enumeration date
08/22/2007
Last updated
09/10/2022
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