Individual
MAXIMO AQUILIZAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
6608 RAYTOWN RD, RAYTOWN, MO 64133-5240
(818) 281-9172
Mailing address
6608 RAYTOWN RD, RAYTOWN, MO 64133-5240
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2022033288
MO
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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