Individual
DR. RAENA SUE DEPERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
401 STAGELINE RD, STE. 6, HUDSON, WI 54016-7897
(715) 531-6710
(715) 531-6711
Mailing address
1119 STATE ST APT 164, RIVER FALLS, WI 54022-3403
(715) 426-0223
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
515-156
WI
231H00000X
Audiologist
8072
FM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
849410000
MHCP
MN
Enumeration date
09/28/2006
Last updated
12/12/2007
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