Individual
TINA SPELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 727-8140
Mailing address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 727-8140
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1943-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42790700
—
WI
Enumeration date
05/15/2007
Last updated
07/08/2007
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