Individual
MS. LAURIE RENEE WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
2817 NEW PINERY RD STE 103, PORTAGE, WI 53901-9257
(608) 745-6290
(608) 745-6250
Mailing address
2817 NEW PINERY RD STE 103, PORTAGE, WI 53901-9257
(608) 745-6290
(608) 745-6250
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2621-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42576100
—
WI
Enumeration date
11/09/2007
Last updated
04/03/2017
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