Individual
HAMMADAH TALIB WAHLQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11288 NW STATE ROAD 20, BRISTOL, FL 32321-3481
(850) 570-7178
Mailing address
13005 NW JOE CHASON CIR, BRISTOL, FL 32321-3144
(850) 570-7178
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
SI3802
FL
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/13/2019
Last updated
08/20/2020
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