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Individual

ANISA WAHEEDUDDIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLPA

Contact information

Practice address
33122 VALLE RD, SAN JUAN CAPISTRANO, CA 92675-4859
(949) 395-0633
Mailing address
21862 BELLCROFT DR, LAKE FOREST, CA 92630-6066
(949) 916-2421

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
2458
CA

Other

Enumeration date
12/05/2018
Last updated
02/08/2019
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