Individual
BOBBIE LIECHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
585 N 400 E, PROVIDENCE, UT 84332-9525
(435) 512-9536
Mailing address
585 N 400 E, PROVIDENCE, UT 84332-9525
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11995049-4102
UT
Other
Enumeration date
07/07/2021
Last updated
07/07/2021
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