Individual
KIT NAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
565 NW HOLLY ST, ISSAQUAH, WA 98027-2834
(425) 837-9613
Mailing address
565 NW HOLLY ST, ISSAQUAH, WA 98027-2834
(425) 837-9613
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL 00002485
WA
Other
Enumeration date
09/27/2012
Last updated
09/27/2012
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