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Individual

ADITHYA CHANDREGOWDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SLP

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA10850
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104342300
FL
01
Y911W
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/16/2017
Last updated
02/16/2021
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