Individual
JENNA BODURTHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
213 ROBINSON ST, WAKEFIELD, RI 02879-3590
(401) 284-1000
Mailing address
3687 POST RD, APT #50, WARWICK, RI 02886-8737
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP00172-P
RI
Other
Enumeration date
02/23/2009
Last updated
02/23/2009
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