Vandermoss, Constance Mary
Vandermoss, Constance Mary is an individual health care provider with primary practice located at 3375 W Brewster St , Appleton WI 54914-1602. 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. Vandermoss, Constance Mary can be contacted via phone (920) 749-5870.Contact Information
Primary practice address
3375 W Brewster St
Appleton WI 54914-1602
Phone: (920) 749-5870
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 342-154 | Wisconsin |
Profile Details
| NPI number | 1184805988 |
|---|---|
| LBN Legal business name | Vandermoss, Constance Mary |
| Credentials | B.S., M.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2007 |
| Last updated | Nov 20th, 2007 - about 18 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 | 1184805988 | NPPES |
| Wisconsin | MEDICAID | 42770700 |
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