Individual
MARISHA BOURGEOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,M.A.
Contact information
Practice address
9109 MENDENHALL MALL RD, SUITE 5K, JUNEAU, AK 99801-7136
(504) 952-2178
Mailing address
1125 B ST, JUNEAU, AK 99801-1533
(504) 952-2178
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
473
AK
Other
Enumeration date
09/28/2016
Last updated
09/28/2016
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