Individual
MS. SHAUNA BOLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7449
Mailing address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7449
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8921489-4102
UT
Other
Enumeration date
03/15/2014
Last updated
03/15/2014
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