Individual
MARY B PRICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC
Contact information
Practice address
E13240 E HILLSDALE DR, FALL CREEK, WI 54742-4209
(715) 672-3909
Mailing address
E13240 E HILLSDALE DR, FALL CREEK, WI 54742-4209
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1151-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
391826964012
ANTHEM BLUE CROSS
WI
05
—
42706800
—
WI
Enumeration date
04/18/2007
Last updated
07/09/2007
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