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Individual

LARISSA LEE TRELOAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
1810 4TH ST SW STE 103A, WAVERLY, IA 50677-4389
(319) 352-1234
(319) 352-4655
Mailing address
1810 4TH ST SW STE 103A, WAVERLY, IA 50677-4389
(319) 352-1234
(319) 352-4655

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
002347
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0665992
IA
Enumeration date
08/14/2013
Last updated
08/14/2013
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