| Elissa Light, MS SLP CCC | |
|
3025 Harbor Ln N, Plymouth, MN 55447-5119 | |
| (612) 321-8957 | |
| Not Available |
| Full Name | Elissa Light |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 3025 Harbor Ln N, Plymouth, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902099922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 2007019046 (Missouri) | Secondary |
| 235Z00000X | Speech-language Pathologist | 8434 (Minnesota) | Primary |
| Provider Name | Odom Sports Medicine Pa |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1275557886 PECOS PAC ID: 0143485607 Enrollment ID: O20120706000533 |
| Provider Name | Onr National Speech Pathology Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1972965952 PECOS PAC ID: 2668463522 Enrollment ID: O20211229000129 |
| Mailing Address | Practice Location Address |
|---|---|
| Elissa Light, MS SLP CCC 2700 Sylvan Rd S, Minnetonka, MN 55305-2820 Ph: (612) 600-1475 | Elissa Light, MS SLP CCC 3025 Harbor Ln N, Plymouth, MN 55447-5119 Ph: (612) 321-8957 |
Kristyne Bazinet, M.S., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447 Phone: 952-544-0349 | |
Kari Shoemaker, M.S Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 5855 Cheshire Parkway, Plymouth, MN 55446 Phone: 763-553-7600 | |
Amber J Bartlett, M.S., CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 14130 23rd Ave N, Plymouth, MN 55447 Phone: 763-383-7666 Fax: 763-383-6013 | |
Megan Stumpf, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 15600 36th Ave N Ste 120, Plymouth, MN 55446 Phone: 763-595-0812 Fax: 763-595-0824 | |
Megan L Wroblewski, MS CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 3021 Harbor Ln N Ste 120, Plymouth, MN 55447 Phone: 763-551-3652 | |
Eric William Ernest, MS Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 14425 8th Ave N, Plymouth, MN 55447 Phone: 763-607-2091 Fax: 763-550-1633 | |
Anne R Lindgren, CCC, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3001 Harbor Ln N, Suite 120, Plymouth, MN 55447 Phone: 763-551-3652 Fax: 763-551-1334 |