Individual
KAITLYN M ANDERLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
701 WILLOW STREET, PESHTIGO, WI 54157-9200
(715) 582-0144
(715) 582-0833
Mailing address
261 FRENCH STREET, PESHTIGO, WI 54157-9200
(715) 582-2020
(715) 582-0803
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4739-154
WI
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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