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

Lisa Fanfulik, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1235304114

Lisa Fanfulik, CCC-SLP is a Speech-Language Pathologist in Maple Grove, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2008
What do these letters mean?
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

9048 Peony Ln N
Maple Grove, MN 55311-4417
Phone: (763) 416-9313
Fax: (763) 416-4530
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 8159 (MN)

Record details

NPI number1235304114
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorYes
NPI enumeratedApril 23, 2008
Last updated in NPPESApril 23, 2008

Other providers in Maple Grove