Individual
MRS. KATHRYN SUSAN VANSICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.CCC-SLP
Contact information
Practice address
59888 PINE CREST DR, MISHAWAKA, IN 46544-9471
(574) 850-4445
(574) 633-4738
Mailing address
59888 PINE CREST DR, MISHAWAKA, IN 46544-9471
(574) 850-4445
(574) 633-4738
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22002407A
IN
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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