Individual
KATIE ELLEN SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, CCC-SLP
Contact information
Practice address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
Mailing address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101001594
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12124109
ASHA
MI
Enumeration date
12/03/2010
Last updated
01/24/2014
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