Individual
MS. WANDA JOAN KIISKILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC- SLP
Contact information
Practice address
25770 ELM ST, CALUMET, MI 49913-1220
(906) 281-1788
Mailing address
25770 ELM ST, CALUMET, MI 49913-1220
(906) 281-1788
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01128628
MI
235Z00000X
Speech-Language Pathologist
7101000233
MI
Other
Enumeration date
06/12/2015
Last updated
06/12/2015
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