Individual
VICTORIA LEEANN DEKOATZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
134 THURBERS AVE, PROVIDENCE, RI 02905-4754
(401) 919-6551
Mailing address
108 NORWOOD AVE # 2, CRANSTON, RI 02905-3915
(401) 410-3176
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP01585
RI
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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