Individual
MISS HOLLY MARIE SUDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.CCC-SLP
Contact information
Practice address
4123 SE 33RD PL, PORTLAND, OR 97202-3444
(503) 758-6978
Mailing address
4123 SE 33RD PL, PORTLAND, OR 97202-3444
(503) 758-6978
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13436
OR
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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