Individual
UNKNOWN MANISHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
421 S ASHER ST, BROWNSTOWN, IN 47220-1832
(617) 304-8549
Mailing address
421 S ASHER ST, BROWNSTOWN, IN 47220-1832
(617) 304-8549
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46002027A
IN
Other
Enumeration date
07/26/2010
Last updated
07/26/2010
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