Doctor Name: | MRS. HOLLY JO DINSMORE |
NPI Number: | 1982744959 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CCC-SLP |
License Number: | 1971-154 |
Business Practice Address: | 6308 8th Avenue Kenosha, WI - 53143 |
Business Phone Number: | 2626563300 |
Business Fax Number: | |
Mailing Address: | 1888 White Lake Dr., ANTIOCH |
State: | IL |
Postal Code: | 60002 |
Phone Number: | 8476031622 |
Fax Number: | |
NPI Enumeration Date: | 02/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1971-154 |
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 |