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

Individual provider Speech-Language Pathologist · NPI 1912846510

Lisa Kerstin Channon I is a Speech-Language Pathologist in Mahtomedi, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2026
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Practice location Address checks out

666 Warner Ave S
Mahtomedi, MN 55115-6882
Phone: (651) 407-2309
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X (MN)

Record details

NPI number1912846510
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 27, 2026
Last updated in NPPESMarch 27, 2026
Certification dateMarch 27, 2026

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