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
Phone: (715) 424-8500
Fax: (715) 424-8502
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457564403 | NPPES |
| Wisconsin | MEDICAID | 42714700 |
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