Lisa A Wicktor, MA CCC SLP - Speech-Language Pathologist in Minneapolis, MN

Lisa A Wicktor, MA CCC SLP is a Speech-language Pathologist based in Minneapolis, Minnesota. Lisa A Wicktor is licensed to practice in Minnesota (license number 5691) and her current practice location is 701 Park Ave, Minneapolis, Minnesota. She can be reached at her office (for appointments etc.) via phone at (612) 873-3899.

NPI number for Lisa A Wicktor is 1104049162 and her current mailing address is 701 Park Ave, Minneapolis, Minnesota. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1104049162.

Contact Information

Lisa A Wicktor, MA CCC SLP
701 Park Ave,
Minneapolis, MN 55415-1623
(612) 873-3899
(612) 904-4326

Map and Direction




Healthcare Provider's Profile

Full NameLisa A Wicktor
GenderFemale
SpecialitySpeech-language Pathologist
Location701 Park Ave, Minneapolis, Minnesota
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1104049162
  • Provider Enumeration Date: 04/10/2007
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Lisa A Wicktor such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104049162NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
235Z00000XSpeech-language Pathologist 5691 (Minnesota)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa A Wicktor is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lisa A Wicktor, MA CCC SLP
701 Park Ave,
Minneapolis, MN 55415-1623

Ph: (612) 873-6005
Lisa A Wicktor, MA CCC SLP
701 Park Ave,
Minneapolis, MN 55415-1623

Ph: (612) 873-3899

Reviews and Comments


Speech-Language Pathologist in Minneapolis, MN

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