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Individual

MATTIE MALLOY MARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED. CF-SLP

Contact information

Practice address
10605 CARTER ST SE, YELM, WA 98597-8486
(360) 458-6020
Mailing address
1695 SEQUALITCHEW DR UNIT 102, DUPONT, WA 98327-6837
(678) 790-0933

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
60772408
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
60772408
WASHINGTON DEPARTMENT OF HEALTH
WA
Enumeration date
12/07/2017
Last updated
12/07/2017
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