Individual
TRISTA ANNE MAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
3415 SHERIDAN RD, KENOSHA, WI 53140-1924
(262) 657-6175
Mailing address
3415 SHERIDAN RD, KENOSHA, WI 53140-1924
(262) 657-6175
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3304-154
WI
Other
Enumeration date
12/08/2009
Last updated
12/08/2009
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