Individual
ALISA VALERNA KAZYUCHITS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
404 RACQUET CLUB BLVD, BEDFORD, TX 76022-6408
(682) 738-3056
Mailing address
1701 TOWNE CROSSING BLVD APT 526, MANSFIELD, TX 76063-8948
(903) 851-0625
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
37293
TX
Other
Enumeration date
09/05/2017
Last updated
09/05/2017
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