Individual
MS. DEVON AMANDA IDALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
109 N 2ND AVE STE 203, ALPENA, MI 49707-5305
(989) 278-8747
(989) 331-6705
Mailing address
16461 PINE ST, PRESQUE ISLE, MI 49777-8653
(810) 305-0627
(989) 331-6705
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101005109
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7101005109
PROFESSIONAL LICENSE
MI
Enumeration date
05/10/2016
Last updated
12/01/2022
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