Individual
MRS. LISA E GOULET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
500 OSBORN BLVD, SAULT SAINTE MARIE, MI 49783-1884
(231) 250-1020
Mailing address
500 OSBORN BLVD, SAULT SAINTE MARIE, MI 49783-1884
(906) 635-4426
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101002796
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7101002796
STATE OF MICHIGAN-DEPT. OF LICENSING AND REGULATORY AFFAIRS
MI
Enumeration date
11/29/2018
Last updated
11/29/2018
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