Individual
SHALEE MYRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
808 MILL LAKE RD, FORT WAYNE, IN 46845-6400
(260) 338-1241
(260) 338-1231
Mailing address
808 MILL LAKE RD, FORT WAYNE, IN 46845-6400
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46002219A
IN
Other
Enumeration date
12/08/2012
Last updated
12/08/2012
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