Individual
MARY C WIATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31815 SOUTHFIELD RD STE 15, BEVERLY HILLS, MI 48025-5471
(248) 885-8240
Mailing address
515 PILGRIM AVE, BIRMINGHAM, MI 48009-1210
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101007229
MI
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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