Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lisa A Wicktor, MACCCSLP

Individual provider Speech-Language Pathologist · NPI 1104049162

Lisa A Wicktor, MACCCSLP is a Speech-Language Pathologist in Minneapolis, Minnesota. Licensed in Minnesota. Registered with an NPI since 2007.

Licensed in
MN
In the registry since
2007

Practice location Address checks out

701 Park Ave
Minneapolis, MN 55415-1623
Phone: (612) 873-3899
Fax: (612) 904-4326
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 5691 (MN)

Record details

NPI number1104049162
Entity typeIndividual (Type 1)
GenderFemale
Credentials MACCCSLP
Sole proprietorNo
NPI enumeratedApril 10, 2007
Last updated in NPPESJuly 8, 2007
Mailing address701 Park Ave, Minneapolis, MN 55415-1623

Other providers in Minneapolis