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1962964064
MARY RICHARDSON
FORT WAYNE, IN
NPI
1962964064
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: IN 22004744A)
Enumeration Date
2019-04-05
Last Update Date
2019-04-05
Business Address
MARY RICHARDSON MA CCC-SLP
5930 HALLOWELL PL
FORT WAYNE, IN 46815-6214
Phone number: 260-409-0687
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Mailing Address
MARY RICHARDSON MA CCC-SLP
5930 HALLOWELL PL
FORT WAYNE, IN 46815-6214
Phone number: 260-409-0687
Copy
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