Individual
STACEY D DIMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1440 ONEIDA ST, N, APPLETON, WI 54915-7101
(920) 731-9579
Mailing address
1960 OAKVIEW DR, NEENAH, WI 54956-1744
(651) 285-2205
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
578-156
WI
231H00000X
Audiologist
8548
MN
Other
Enumeration date
09/15/2009
Last updated
01/20/2015
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