Individual
MARIA FENICLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
2922 FULLER AVE NE STE 107, GRAND RAPIDS, MI 49505-3459
(616) 570-0925
Mailing address
2922 FULLER AVE NE STE 107, GRAND RAPIDS, MI 49505-3459
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
12/22/2022
Last updated
12/22/2022
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