Moldenhauer, Tim Edward

Moldenhauer, Tim Edward is an individual health care provider with primary practice located at 410 Dewey St , Wisconsin Rapids WI 54494-4715. He recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as his primary health care specialty. Moldenhauer, Tim Edward can be contacted via phone (715) 424-8500.

Contact Information

Primary practice address
410 Dewey St Wisconsin Rapids WI 54494-4715
Fax: (715) 424-8502
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 607-154 Wisconsin

Profile Details

NPI number 1457564403
LBN Legal business name Moldenhauer, Tim Edward
Credentials MS-CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2007
Last updated Mar 13th, 2013 - about 13 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 1457564403 NPPES
Wisconsin MEDICAID 42714700

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