Individual
HAYDEN GANDOLFI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2715 LILAC ST, LONGVIEW, WA 98632-3526
(360) 575-7000
Mailing address
27077 DARTMOUTH ST, MADISON HEIGHTS, MI 48071-3235
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101007378
MI
Other
Enumeration date
04/21/2022
Last updated
04/21/2022
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