Individual
ANDREA K. BOTWINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED, CCC-SLP
Contact information
Practice address
ROSEBURG SCOTTISH RITE CLINIC, 920 SE CASS, RM. 208, ROSEBURG, OR 97470
(541) 440-3040
Mailing address
ROSEBURG SCOTTISH RITE CLINIC, 920 SE CASS, RM. 208, ROSEBURG, OR 97470
(541) 440-3040
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11241
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051412
—
OR
Enumeration date
02/07/2007
Last updated
07/08/2007
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