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Individual

DORA DELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC

Contact information

Practice address
5601 HATCHERY RD, WATERFORD, MI 48329-3451
(248) 674-9292
Mailing address
54109 SUNDERLAND DR, SHELBY TOWNSHIP, MI 48316-1970

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101000855
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7101000855
STATE OF MICHIGAN DEPT OF LICENSING AND REGULATORY AFFAIRS
MI
Enumeration date
04/21/2013
Last updated
04/21/2013
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