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NPI Code Detail

MEDICARE: LACI MINARD MA, CCC-SLP

MEDICARE: LACI MINARD MA, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist001925IA

General Provider Information

NPI Number : 1174005839
Entity Type Code : Individual
Provider Name (Legal Business Name) : LACI MINARD MA, CCC-SLP
Provider Business Mailing Address
First Line : 1700 3RD ST NE
Second Line :
City : INDEPENDENCE
State : IA
Zip : 50644-2264
Country : US
Telephone Number : 319-334-7015
Fax Number :
Provider Business Practice Location Address
First Line : 1700 3RD ST NE
Second Line :
City : INDEPENDENCE
State : IA
Zip : 50644-2264
Country : US
Telephone Number : 319-334-7015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2018
Last Update Date : 08/29/2018

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Directions to “ LACI MINARD MA, CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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