Audrey Denboer, OTR

Individual provider Active NPI Speech-Language Pathologist · Remsen, IA

NPI 1104028034 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104028034
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
01647 (IA)
Practice address
423 Roosevelt Ave
Remsen, IA 51050-1074
Phone
(615) 896-6400
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
01647IAMDObstetrics & Gynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 01647 IA Yes

Addresses

Primary practice location

423 Roosevelt Ave
Remsen, IA 51050-1074

Mailing address

101 4TH Ave SE
Sioux Center, IA 51250-2205
Phone (712) 722-0974

Other providers in Remsen, IA

All providers in Remsen, IA · Speech-Language Pathologist in Iowa

Sources for this page

Verify at the official NPI Registry.