Individual
MRS. SHANELL KEHAULANI LATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
22 VELVA DR, KALISPELL, MT 59901-6326
(406) 212-8670
Mailing address
22 VELVA DR, KALISPELL, MT 59901-6326
(406) 212-8670
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-SP-TMP-4108
MT
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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