Individual
MOIRA JEAN HETLAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. SLP
Contact information
Practice address
1515 24TH AVE, SEATTLE, WA 98122-3008
(425) 456-5160
Mailing address
1515 24TH AVE, SEATTLE, WA 98122-3008
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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