Mallory Jean Waisanen, CCC-SLP
Speech-Language Pathologist, in Flint, MI. Individual provider (NPI-1).
NPI number1114402575
StatusActive
Last updated in NPPESDec 8, 2022
Details
- NPI
- 1114402575
- Entity type
- Individual (NPI-1)
- Name
- Mallory Jean Waisanen
- Credential
- CCC-SLP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 1, 2018
- Certification date
- Dec 8, 2022
- Last updated
- Dec 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 7101005773 | MI | Yes |
Practice location
1 Hurley PlzFlint, MI 48503-5902
Phone 810-429-8923
Mailing address
9437 Sheridan RdGaines, MI 48436-8933
Phone 810-429-8923
Other practice locations
2919 Wilder Rd
Bay City, MI 48706-9299
Bay City, MI 48706-9299
Phone 989-671-5738
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Other Speech-Language Pathologist providers in Flint, MI
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- Kelsey BowlesNPI 1083190169
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All 57 Speech-Language Pathologist providers in Flint · All 7,738 providers in Flint
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