Individual
MARY VIOLET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29 NORTH 6TH AVE, BELLE FOURCHE, SD 57717
(605) 723-3355
Mailing address
38 OLSON RD, ALADDIN, WY 82710-9707
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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