Individual
JAIDEN RAISHEL SHADWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
325 LARIAT DR, GALLIPOLIS, OH 45631-1403
(740) 645-7467
Mailing address
325 LARIAT DR, GALLIPOLIS, OH 45631-1403
(740) 645-7467
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP.13892
OH
Other
Enumeration date
05/21/2020
Last updated
05/21/2020
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