Organization
RISA ITANI MS CCC-SLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RISA ITANI MS CCC-SLP (SOLE MEMBER/MANAGER)
(352) 209-6494
Entity
Organization
Contact information
Practice address
235 SE DAVIS AVE, BEND, OR 97702-1333
(541) 241-6153
Mailing address
1240 SW 16TH ST, REDMOND, OR 97756-2906
(352) 209-6494
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
10/29/2019
Last updated
10/31/2019
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