Thomas David Petersen in Delavan - Speech-language Pathologist
Thomas David Petersen - NPI 1134249246
Thomas David Petersen is a Speech-language Pathologist in Delavan, Wisconsin. Thomas David Petersen practices all healthcare services and medical treatments related to Speech-language Pathologist. The NPI Number for Thomas David Petersen is 1134249246. The last update date is 2007-07-08.
Thomas David Petersen's current location address is N4901 Dam Rd, Delavan, Wisconsin. You can contact this provider via phone number 2627402170 and fax number 2627407201. The mailing address for Thomas David Petersen is N4901 Dam Rd, Delavan, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Thomas David Petersen |
|---|---|
| Address | N4901 Dam Rd, Delavan, Wisconsin |
| Phone Number | 2627402170 |
| Fax Number | 2627407201 |
| Sole Proprietor | N |
| Credentials | MSCCCSLP |
NPI Number Detail
| NPI Number | 1134249246 |
|---|---|
| Provider Enumeration Date | 2007-03-30 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | N4901 Dam Rd |
|---|---|
| City | Delavan |
| State | Wisconsin (WI) |
| Post Code | 531152927 |
| Phone Number | 2627402170 |
| Fax Number | 2627407201 |
Provider's Primary Taxonomy Detail
| Speciality | Speech-language Pathologist |
|---|---|
| Taxonomy | 235Z00000X |
| Licence No | 2444154 |
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Definition: The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Spe |
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What is the unique identifier code issued to Thomas David Petersen by the Centers for Medicare & Medicaid Services?
The Thomas David Petersen has been assigned the NPI (National Provider Identifier) 1134249246. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Thomas David Petersen's physical address?
The Thomas David Petersen is physically located at N4901 Dam Rd, in the city of Delavan, WI, with the postal code 531152927.
What is Thomas David Petersen's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Thomas David Petersen is Speech-language Pathologist, and the taxonomy classification code that categorizes this area of expertise is 235Z00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1134249246 to Thomas David Petersen?
The Centers for Medicare & Medicaid Services originally issued the 1134249246 to Thomas David Petersen on 2007-03-30.
As of what date were the Thomas David Petersen's details last updated?
The information pertaining to the Thomas David Petersen, including its address, specialty, and other details, was most recently updated on 2007-07-08.