Individual
MRS. CONSTANCE MARY VANDERMOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S., M.S.
Contact information
Practice address
3375 W BREWSTER ST, APPLETON, WI 54914-1602
(920) 749-5870
Mailing address
W6055 GOLDEN CT, APPLETON, WI 54915-7464
(920) 739-6273
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
342-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42770700
—
WI
Enumeration date
11/20/2007
Last updated
11/20/2007
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