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Individual

STEPHANIE BUSHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
926 WILLARD DR STE 114, GREEN BAY, WI 54304-5071
(920) 592-9330
(920) 592-9320
Mailing address
1495 WHITETAIL DR, NEENAH, WI 54956-4485

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3290-154
WI

Other

Enumeration date
09/08/2009
Last updated
09/08/2009
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