Individual
THERESA TARGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
808 S GARFIELD AVE, SUITE A, TRAVERSE CITY, MI 49686-3464
(231) 929-2354
Mailing address
8801 SECTION LINE RD, INTERLOCHEN, MI 49643-9344
(248) 739-1694
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12084553
MI
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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