| Doctor Name: | LARISSA LEE TRELOAR |
| NPI Number: | 1477986313 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 002347 |
| Business Practice Address: | 1810 4th St Sw Ste 103a Waverly, IA - 506774389 |
| Business Phone Number: | 3193521234 |
| Business Fax Number: | 3193524655 |
| Mailing Address: | 1810 4th St Sw Ste 103a, WAVERLY |
| State: | IA |
| Postal Code: | 506774389 |
| Phone Number: | 3193521234 |
| Fax Number: | 3193524655 |
| NPI Enumeration Date: | 08/14/2013 |
| NPI Last Update Date: | 08/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 002347 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| 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 |