Individual
MRS. ANNE FANTAUZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 W JEFFERSON ST, SPRINGFIELD, OH 45506-1224
(937) 505-2800
Mailing address
2057 DERBY DR, MARYSVILLE, OH 43040-8152
(937) 926-0035
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP.10106
OH
Other
Enumeration date
04/21/2017
Last updated
04/21/2017
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