Individual
ALISE EVON LEGUIZAMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC/SLP
Contact information
Practice address
204 S ADAMS ST, SAINT CROIX FALLS, WI 54024-9449
(715) 483-3221
(715) 483-0507
Mailing address
204 S ADAMS ST, SAINT CROIX FALLS, WI 54024-9449
(715) 483-3221
(715) 483-0507
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
425-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42759000
—
WI
Enumeration date
10/24/2007
Last updated
10/24/2007
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