Doctor Name: | MS. CAROL K LANZA |
NPI Number: | 1023313426 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS-CCC/SLP |
License Number: | 395154 |
Business Practice Address: | 210 E Park Ave Luck, WI - 548539066 |
Business Phone Number: | 7154723114 |
Business Fax Number: | |
Mailing Address: | 6492 Burnikel Rd, SIREN |
State: | WI |
Postal Code: | 548729118 |
Phone Number: | 7153495279 |
Fax Number: | |
NPI Enumeration Date: | 01/14/2011 |
NPI Last Update Date: | 01/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 395154 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |