Individual
LACEY AYLESWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3905 87TH AVE NE, MARYSVILLE, WA 98270-6821
(425) 350-5223
Mailing address
3905 87TH AVE NE, MARYSVILLE, WA 98270-6821
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60611595
WA
Other
Enumeration date
11/24/2015
Last updated
11/24/2015
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