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Individual

JEANNETTE K MAHARAJ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5306 TRAIL LAKE DR, FORT WORTH, TX 76133-1931
(817) 433-0721
Mailing address
1717 BOXWOOD LN, WYLIE, TX 75098-8168

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
35313
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149984001
TX
Enumeration date
12/29/2009
Last updated
12/29/2009
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