Individual
MARIAH WELLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1510 E BROADWAY ST, BOLIVAR, MO 65613-1246
(417) 399-6966
Mailing address
1510 E BROADWAY ST, BOLIVAR, MO 65613-1246
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
12/13/2019
Last updated
09/22/2022
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