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Individual

ALEISHA WILBER VANAMBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CCC SLP

Contact information

Practice address
207 CRYSTAL GROVE BLVD, LUTZ, FL 33548-6409
(813) 848-0341
(813) 540-8271
Mailing address
207 CRYSTAL GROVE BLVD, LUTZ, FL 33548-6409
(813) 848-0341
(813) 540-8271

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA6573
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
887426300
FL
01
S2436
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/11/2007
Last updated
12/12/2024
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