Individual
MRS. KATHRYN L SOUTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
2314 YORKSHIRE RD STE 200, ANN ARBOR, MI 48104-5041
(734) 973-9670
Mailing address
11399 MASTERS RD, RILEY, MI 48041-2604
(586) 817-3997
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101001028
MI
Other
Enumeration date
05/06/2015
Last updated
05/06/2015
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