Doctor Name: | ALISE EVON LEGUIZAMON |
NPI Number: | 1255510434 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC/SLP |
License Number: | 425-154 |
Business Practice Address: | 204 S Adams St Saint Croix Falls, WI - 540249449 |
Business Phone Number: | 7154833221 |
Business Fax Number: | 7154830507 |
Mailing Address: | 204 S Adams St, SAINT CROIX FALLS |
State: | WI |
Postal Code: | 540249449 |
Phone Number: | 7154833221 |
Fax Number: | 7154830507 |
NPI Enumeration Date: | 10/24/2007 |
NPI Last Update Date: | 10/24/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 425-154 |
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 |