Individual
KIM ELLEN WEISENSEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
126 PHOENIX AVE BLDG 2, LOWELL, MA 01852-4931
(978) 453-8331
Mailing address
126 PHOENIX AVE BLDG 2, LOWELL, MA 01852-4931
(978) 453-8331
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3677
MA
Other
Enumeration date
11/13/2007
Last updated
11/13/2007
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