Individual
MRS. SALLY BERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 HUNTINGTON AVE S, CASTLE ROCK, WA 98611-8902
(360) 501-2910
Mailing address
700 HUNTINGTON AVE S, CASTLE ROCK, WA 98611-8902
(360) 501-2910
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60405634
WA
Other
Enumeration date
12/02/2013
Last updated
12/02/2013
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