Individual
ELISE DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2280 TOWER HILL RD, HOUGHTON LAKE, MI 48629-8961
(989) 422-5153
Mailing address
3049 WAUSAUKEE DR NE, GRAND RAPIDS, MI 49525-1916
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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