Individual
DONNA MERLE BOULETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1950 LIVE OAK ST, SAN ANGELO, TX 76901-3944
(325) 315-3146
Mailing address
1950 LIVE OAK ST, SAN ANGELO, TX 76901-3944
(325) 315-3146
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
80195
TX
235Z00000X
Speech-Language Pathologist
Primary
103968
TX
Other
Enumeration date
08/17/2010
Last updated
08/17/2010
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