Individual
REBECCA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
4121 PENNSYLVANIA AVE, DUBUQUE, IA 52002-2628
(563) 583-4003
Mailing address
4121 PENNSYLVANIA AVE, DUBUQUE, IA 52002-2628
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
87057
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033664800
SPEECH LANGUAGE PATHOLOGIST
ND
Enumeration date
08/22/2016
Last updated
03/17/2018
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