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Individual

MRS. ANGELA RAE DEROUIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
200 N PATRICK BLVD STE 250, BROOKFIELD, WI 53045-5883
(262) 255-1180
(262) 255-1638
Mailing address
200 N PATRICK BLVD STE 250, BROOKFIELD, WI 53045-5883
(888) 754-0398

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3231-154

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100007790
WI
Enumeration date
12/04/2009
Last updated
09/25/2023
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