ANITA MARIA VIVANCO

CLARKSVILLE, IN
NPI1558034652
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: IN  46003948A)
Additional Taxonomies235Z00000X Speech-Language Pathologist,
(Licence: KY  271925)
Enumeration Date2021-07-26
Last Update Date2021-07-27
Business Address
ANITA MARIA VIVANCO
1329 APPLEGATE LN
CLARKSVILLE, IN 47129-9612
Phone number: 502-633-1007
Mailing Address
ANITA MARIA VIVANCO
90 HOWARD DR
SHELBYVILLE, KY 40065-8138
Phone number: 502-320-3318