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Individual

CARLY BETH REISER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
320 PACIFIC PL, MOUNT VERNON, WA 98273-5463
(360) 416-7570
(360) 416-7580
Mailing address
PO BOX 814, WINTHROP, WA 98862-0814
(509) 996-8234
(509) 996-2193

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL60197867
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LL60261200
DOH LICENSE
WA
Enumeration date
12/13/2010
Last updated
11/20/2024
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