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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 17 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 1912128216 NPPES
Florida Other 12049301 ASHA LICENSE #
Florida Other SA 5673 ASHA LICENSE #

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