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Individual

MRS. CHANA WAX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
113 LINCOLNWAY E, MISHAWAKA, IN 46544-2016
(443) 608-0169
Mailing address
3327 S TWYCKENHAM DR, SOUTH BEND, IN 46614-2153
(443) 608-0169

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22006120A
IN

Other

Enumeration date
06/10/2015
Last updated
06/10/2015
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