Healthcare Provider Details

I. General information

NPI: 1467398784
Provider Name (Legal Business Name): ANNIKA MARIT LIEN M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 4000
WALKER MN
56484-4000
US

IV. Provider business mailing address

7495 HILLSDALE LOOP NW
WALKER MN
56484-2180
US

V. Phone/Fax

Practice location:
  • Phone: 218-547-1311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1020704
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: