Individual
MS. MELANIE MARION TAVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1323 CRESTON PARK DR, JANESVILLE, WI 53545-1126
(608) 756-9440
Mailing address
1323 CRESTON PARK DR, JANESVILLE, WI 53545-1126
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3110-154
WI
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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