Individual
MIRANDA LEE WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
171 S FAIR OAKS AVE APT 528, MADISON, WI 53704-5869
(000) 000-0000
Mailing address
171 S FAIR OAKS AVE APT 528, MADISON, WI 53704-5869
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4850-154
WI
Other
Enumeration date
06/11/2019
Last updated
11/29/2021
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