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1164707170
PAMELA ANNA WYSUPH
FORT WORTH, TX
NPI
1164707170
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: TX 13245)
Enumeration Date
2011-10-21
Last Update Date
2011-10-21
Business Address
-- PAMELA ANNA WYSUPH
5316 TRAIL LAKE DR
FORT WORTH, TX 76133-1931
Phone number: 817-292-8787
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Mailing Address
-- PAMELA ANNA WYSUPH
5316 TRAIL LAKE DR
FORT WORTH, TX 76133-1931
Phone number: 817-292-8787
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