Individual
GIRIRAJ ETHIRAJU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA SLP
Contact information
Practice address
8230 NECTAR DRIVE, APT 726, CANTON, MI 48187
(734) 502-8808
Mailing address
8230 NECTAR DR, APT 726, CANTON, MI 48187-7117
(734) 502-8808
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101000753
MI
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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