Doctor Name: | LYNNE GIACOMINO DUGOLENSKI |
NPI Number: | 1659551380 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A.,CCC/SLP |
License Number: | 294-154 |
Business Practice Address: | 2817 New Pinery Rd Suite 103 Portage, WI - 539019257 |
Business Phone Number: | 6087456290 |
Business Fax Number: | 6087456250 |
Mailing Address: | 2817 New Pinery Rd, Suite 103 PORTAGE |
State: | WI |
Postal Code: | 539019257 |
Phone Number: | 6087456290 |
Fax Number: | 6087456250 |
NPI Enumeration Date: | 11/09/2007 |
NPI Last Update Date: | 11/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 294-154 |
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 |