Individual
MS. CONNIE TODD MANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
502 4TH ST NE, AUBURN, WA 98002-5020
(250) 931-4927
(253) 931-4742
Mailing address
502 4TH ST NE, AUBURN, WA 98002-5020
(250) 931-4927
(253) 931-4742
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL 00004304
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01082902
ASHA CCC #
—
01
—
LL00004304
WA DOH LICENSE
WA
Enumeration date
09/12/2012
Last updated
09/12/2012
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