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Individual

DENICE MICHELLE EDEAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
201 N MERIDIAN ST, SUITE B, NEWBERG, OR 97132-2752
(503) 901-5652
Mailing address
2000 NE 42ND AVE # 209, PORTLAND, OR 97213-1399
(503) 309-1089

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13086
OR

Other

Enumeration date
06/25/2012
Last updated
06/25/2012
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