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Individual

KELLY A WIEGARDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, CCC-SLP

Contact information

Practice address
1302 W ALICE AVE, SPOKANE, WA 99205-2708
(360) 244-3085
Mailing address
12414 S ANDRUS RD, CHENEY, WA 99004-8607
(509) 559-4599

Taxonomy

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

Other

Enumeration date
12/16/2018
Last updated
12/16/2018
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