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Individual

KAMI RAE THALLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
515 N MAIN ST, AVILLA, IN 46710-9601
(260) 897-2841
Mailing address
5437 COVENTRY LN APT 304, FORT WAYNE, IN 46804-7177
(812) 350-5020

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
12/02/2024
Last updated
12/02/2024
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