Individual
MACEY MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
131 N POPLAR AVE, TEA, SD 57064-2152
(605) 498-2700
Mailing address
4321 W 58TH ST UNIT 6, SIOUX FALLS, SD 57108-6516
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1058-PROV
SD
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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