Doctor Name: | HOLLY A DEROOS |
NPI Number: | 1063603488 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 7490 156th St Chippewa Falls, WI - 547291425 |
Business Phone Number: | 7157263447 |
Business Fax Number: | 7157263649 |
Mailing Address: | 2661 County Highway I, CHIPPEWA FALLS |
State: | WI |
Postal Code: | 547295407 |
Phone Number: | 7157263447 |
Fax Number: | 7157263649 |
NPI Enumeration Date: | 08/09/2007 |
NPI Last Update Date: | 08/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |