Individual
COLLEEN RUTH CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7126 AZALEA SQ, SAN ANTONIO, TX 78218-3111
(501) 554-0854
Mailing address
7126 AZALEA SQ, SAN ANTONIO, TX 78218-3111
(501) 554-0854
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
34859
—
Other
Enumeration date
08/10/2018
Last updated
08/10/2018
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