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NPI Code Detail

MEDICARE: KIRSTEN DANIELLE TODD SLP

MEDICARE:   KIRSTEN DANIELLE TODD  SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist7101006468MI

General Provider Information

NPI Number : 1659904415
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRSTEN DANIELLE TODD SLP
Provider Business Mailing Address
First Line : 2511 WALDO AVE
Second Line :
City : MIDLAND
State : MI
Zip : 48642-5246
Country : US
Telephone Number : 310-344-5723
Fax Number :
Provider Business Practice Location Address
First Line : 6700 WESTSIDE SAGINAW RD
Second Line :
City : BAY CITY
State : MI
Zip : 48706-9325
Country : US
Telephone Number : 989-667-9800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2020
Last Update Date : 02/19/2020

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Directions to “ KIRSTEN DANIELLE TODD SLP” Practice Location

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