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Individual

ERIC VIANELLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S.CCC-SLP

Contact information

Practice address
5117 8TH AVE, SACRAMENTO, CA 95820-1601
(916) 267-7262
Mailing address
5117 8TH AVE, SACRAMENTO, CA 95820-1601
(916) 267-7262

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 11255
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SP 11255
STATE OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS
CA
Enumeration date
03/04/2010
Last updated
03/04/2010
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