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Individual

LOUISE MARIE SEA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MCSD, CCC-SLP

Contact information

Practice address
145 SE SALMON AVE, REDMOND, OR 97756-8427
(541) 923-8900
Mailing address
1457 NW LEWIS ST, BEND, OR 97701-6717
(541) 389-3362

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10657
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00756726
ASHA MEMBER
01
10657
BOARD LICENSE
OR
Enumeration date
04/03/2007
Last updated
07/08/2007
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