Individual
MADISON ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8175 MOVIE DR, BRIGHTON, MI 48116-7444
(248) 277-3005
Mailing address
57574 GOODISON APT 15216, NEW HUDSON, MI 48165-7056
(248) 921-7732
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7152001063
MI
Other
Enumeration date
01/02/2025
Last updated
01/02/2025
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