Individual
TIFFANY VANDE ZANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
199 HOME RD, JUNEAU, WI 53039-1401
(920) 386-3548
Mailing address
245 ROUNSVILLE ST, WAUPUN, WI 53963-1535
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2677-154
WI
Other
Enumeration date
09/17/2006
Last updated
07/08/2007
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