Individual
CAROL L. MCDOUGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
230 E NORTH AVE, ANTIGO, WI 54409-2758
(715) 623-9101
Mailing address
230 E NORTH AVE, ANTIGO, WI 54409-2758
(715) 623-9101
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
132154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42654600
—
WI
Enumeration date
04/04/2008
Last updated
04/04/2008
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