Doctor Name: | MRS. JACQUELINE JAN THINGVOLD |
NPI Number: | 1447427687 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC SLP |
License Number: | 1091-154 |
Business Practice Address: | E7404a County Bb Viroqua, WI - 546651139 |
Business Phone Number: | 6086375400 |
Business Fax Number: | |
Mailing Address: | 3149 26th St S, LA CROSSE |
State: | WI |
Postal Code: | 546017654 |
Phone Number: | 6087875576 |
Fax Number: | |
NPI Enumeration Date: | 05/15/2008 |
NPI Last Update Date: | 05/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1091-154 |
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 |