Individual
BRIAN WISHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, CCC-SLP
Contact information
Practice address
138 LAKE ADA CIR, SANFORD, FL 32773-5659
(407) 328-5336
(407) 328-5336
Mailing address
138 LAKE ADA CIR, SANFORD, FL 32773-5659
(407) 328-5336
(407) 328-5336
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA5430
FL
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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