Individual
VIJITHA KOTHAKONDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(925) 689-7457
Mailing address
1945 LEHIGH DR, DAVIS, CA 95616-4007
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
18293
CA
Other
Enumeration date
04/25/2017
Last updated
04/25/2017
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