NPI 1063661916

Mary Alice Petersen, MACCCSLP

Practitioner Speech-Language Pathologist Newcastle, WY

Practice location

Address: 104 Stampede St, Newcastle, WY 82701-3037
Phone: (307) 746-4560

Registered specialties

Speech-Language Pathologist Primary

Speech, Language and Hearing Service Providers Taxonomy 235Z00000X Licence #SP-391 (WY)

Other Speech-Language Pathologist providers in Wyoming →

Registry record

NPI: 1063661916
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Sep 2008
Record last updated: 15 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.