Individual
KIMBERLY ANTUSHEVICH ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-0660
(248) 964-0665
Mailing address
44300 DEQUINDRE RD, STERLING HEIGHTS, MI 48314-1003
(248) 964-0660
(248) 964-0665
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101001147
MI
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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