Wamboldt, Deana Susan
Wamboldt, Deana Susan is an sole proprietor health care provider with primary practice located at 2310 S.W. 34Th Ave. , Fort Lauderdale FL 33312. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Wamboldt, Deana Susan can be contacted via phone (954) 257-8567.Contact Information
Primary practice address
2310 S.W. 34Th Ave.
Fort Lauderdale FL 33312
Phone: (954) 257-8567
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SA 5673 | Florida |
Profile Details
| NPI number | 1912128216 |
|---|---|
| LBN Legal business name | Wamboldt, Deana Susan |
| Credentials | M.S., CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 2nd, 2007 |
| Last updated | Jul 9th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912128216 | NPPES |
| Florida | Other | 12049301 | ASHA LICENSE # |
| Florida | Other | SA 5673 | ASHA LICENSE # |
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