Individual
SUE ELLEN LEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891
Mailing address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01063855
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01063855
ASHA CERTIFICATION
MI
Enumeration date
08/26/2008
Last updated
08/26/2008
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