Individual
MARSHA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1760 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 499-5191
Mailing address
1760 SHAWANO AVE, GREEN BAY, WI 54303-3216
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1550
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42786000
—
WI
Enumeration date
05/14/2008
Last updated
05/14/2008
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