Individual
KYSA LYNDELL DEITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1625 E MAIN ST, CLINTONVILLE, WI 54929-8407
(715) 823-3135
Mailing address
E2606 1151ST AVE, BOYCEVILLE, WI 54725-9473
(715) 931-8479
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
WI
Other
Enumeration date
05/31/2019
Last updated
09/19/2022
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