Debra Jean Doeksen-Gould, MA CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Newcastle, WY

NPI 1245587732 · NPPES record last updated Aug 14, 2012

Key facts

NPI
1245587732
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
269 (WY)
Practice address
104 Stampede St
Newcastle, WY 82701-3037
Phone
(307) 745-4560
NPI assigned
Aug 14, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
269WYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 269 WY Yes

Addresses

Primary practice location

104 Stampede St
Newcastle, WY 82701-3037

Mailing address

104 Stampede
Weston County Children'S Center
Newcastle, WY 82701-3037
Phone (307) 745-4560

Other providers in Newcastle, WY

All providers in Newcastle, WY · Speech-Language Pathologist in Wyoming

Sources for this page

Verify at the official NPI Registry.