Individual
MRS. ALISHA PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
3325 WILLOWCREEK RD, PORTAGE, IN 46368-5015
(219) 764-4888
(219) 764-4805
Mailing address
3325 WILLOWCREEK RD, PORTAGE, IN 46368-5015
(219) 764-4888
(219) 764-4805
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004379A
IN
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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