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1114402575
MALLORY JEAN WAISANEN
FLINT, MI
NPI
1114402575
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: MI 7101005773)
Enumeration Date
2018-10-01
Last Update Date
2022-12-08
Business Address
MALLORY JEAN WAISANEN CCC-SLP
1 HURLEY PLZ
FLINT, MI 48503-5902
Phone number: 810-429-8923
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Mailing Address
MALLORY JEAN WAISANEN CCC-SLP
9437 SHERIDAN RD
GAINES, MI 48436-8933
Phone number: 810-429-8923
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