Individual
MADISON GRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2126 DIXON AVE, MISSOULA, MT 59801-8226
(406) 541-2776
Mailing address
2126 DIXON AVE, MISSOULA, MT 59801-8226
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-SP-LIC-11564
MT
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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