Provider Demographics
NPI:1942893128
Name:MCNELIS, LORI JOAN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:JOAN
Last Name:MCNELIS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:JOAN
Other - Last Name:SAVRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 SECOND ST. N.E.
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418
Mailing Address - Country:US
Mailing Address - Phone:612-789-1236
Mailing Address - Fax:
Practice Address - Street 1:A CHANCE TO GROW
Practice Address - Street 2:1800 SECOND ST. N.E.
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418
Practice Address - Country:US
Practice Address - Phone:612-789-1236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist