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Individual

MICHELLE M LEBAS-BOWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 767-7174
Mailing address
252 MCHENRY ST, BURLINGTON, WI 53105-1828
(262) 767-7174

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1516
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42761100
WI
Enumeration date
12/06/2007
Last updated
12/06/2007
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