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Individual
MRS. MANDY H NUTLEY
Active
Individual
MRS. MANDY H NUTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHS CCC SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22001692A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200645490
—
IN
05
—
200716000A
—
IN
Enumeration date
06/26/2006
Last updated
09/02/2008
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