Individual
MRS. MARY RUTH BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC SLP
Contact information
Practice address
3056 LINDSAY LN, PORT HURON, MI 48060-7777
(810) 434-2105
Mailing address
3056 LINDSAY LN, PORT HURON, MI 48060-7777
(810) 434-2105
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101001523
MI
Other
Enumeration date
03/03/2019
Last updated
03/03/2019
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