Individual
MANDI JO BAXENDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 1191, POWELL, WY 82435-1191
(307) 754-9829
Mailing address
PO BOX 1191, POWELL, WY 82435-1191
(307) 754-9829
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-1326
WY
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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