Individual
MISS AMANDA NICOLE IHLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
472 PARK LN, HUDSON, WI 54016-7524
(414) 339-4202
Mailing address
472 PARK LN, HUDSON, WI 54016-7524
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005776
VA
Other
Enumeration date
03/08/2010
Last updated
03/08/2010
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