Individual
MCKAYLA FIELSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS-CF
Contact information
Practice address
902 PROVIDENT DR STE C, WARSAW, IN 46580-3379
(574) 376-2316
Mailing address
902 PROVIDENT DR STE C, WARSAW, IN 46580-3379
(574) 376-2316
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46004233A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46004233A
SLP-CFY LICENSE NUMBER
IN
Enumeration date
06/15/2023
Last updated
06/21/2023
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