Provider Demographics
NPI:1659259570
Name:LENARZ, ELLIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ELLIE
Middle Name:
Last Name:LENARZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 LAKEWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-6730
Mailing Address - Country:US
Mailing Address - Phone:320-296-4529
Mailing Address - Fax:
Practice Address - Street 1:6533 FLYING CLOUD DR STE 200
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3335
Practice Address - Country:US
Practice Address - Phone:952-215-3769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLICC-3901235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist