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Individual

MARCELLINE CHRISTINE CRUZ PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
801 S KLEIN DR, WAUNAKEE, WI 53597-1575
(608) 849-5016
(608) 849-6516
Mailing address
801 S KLEIN DR, WAUNAKEE, WI 53597-1575
(608) 849-5016
(608) 849-6516

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1786-154
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42783200
WI
Enumeration date
05/13/2008
Last updated
05/13/2008
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