Individual
TASHA JOY MALVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA/CCC-SLP
Contact information
Practice address
1673 DOUSMAN STREET, GREEN BAY, WI 54307-2770
(920) 593-4382
Mailing address
1673 DOUSMAN STREET, GREEN BAY, WI 54307-2770
(920) 593-4382
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2613-154
WI
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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