Deperry, Raena Sue

Deperry, Raena Sue is an individual health care provider with primary practice located at 401 Stageline Rd Ste. 6, Hudson WI 54016-7897. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Deperry, Raena Sue can be contacted via phone (715) 531-6710.

Contact Information

Primary practice address
401 Stageline Rd Ste. 6 Hudson WI 54016-7897
Phone: (715) 531-6710
Fax: (715) 531-6711
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 8072 Fm
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 515-156 Wisconsin

Profile Details

NPI number 1114018447
LBN Legal business name Deperry, Raena Sue
Credentials AUD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2006
Last updated Dec 12th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114018447 NPPES
Minnesota Other 849410000 MHCP

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