Individual
BECKY DEROSIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
8332 NORTHWESTERN AVE, RACINE, WI 53406-1722
(262) 619-4578
Mailing address
8332 NORTHWESTERN AVE, RACINE, WI 53406-1722
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1590066924
WI
Other
Enumeration date
06/09/2026
Last updated
06/09/2026
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