Individual
SHANDA BODDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 TROUP HWY, TYLER, TX 75703-2356
(903) 939-2800
Mailing address
PO BOX 250, VAN ALSTYNE, TX 75495-0250
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
32265
TX
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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