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Speech, Language and Hearing Service Providers Speech-Language Pathologist

Provider NPI: 1538687991

Provider Information:
Gender: F
Sole Proprietor

Practice Location:
Tel: 920-458-2137  Fax: --

Business Mailing Address:
835 S VAN BUREN ST  GREEN BAY, WI 54301-3526 US
Tel: 920-433-0111  Fax: --

NPI Information:
NPI: 1538687991
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 235Z00000X





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