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General NPI Number Information
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NPI Number | 1306753231
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Entity Type | Individual
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Provider Name | LILIAN MAE ZACK CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 2835 W SAINT GERMAIN ST STE 300
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City | SAINT CLOUD
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State | MN
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Zip | 56301-6281
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Country | US
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Telephone | 320-259-4151
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 2ND ST S
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City | WAITE PARK
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State | MN
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Zip | 56387-2325
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Country | US
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Telephone | 320-370-8000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 1044013
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | LICC-4480
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License Number State | MN
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