Individual
DALE MARIE SANDUSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
179 COMBS ST, SPARTA, NC 28675-8429
(336) 372-2441
Mailing address
179 COMBS ST, SPARTA, NC 28675-8429
(336) 372-2441
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6921
NC
235Z00000X
Speech-Language Pathologist
SA 11953
FL
Other
Enumeration date
02/19/2008
Last updated
01/09/2013
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