Individual
CAROLYN AVERILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
1003 W DEVONSHIRE RD, DELAFIELD, WI 53018-1923
(262) 370-0839
Mailing address
134 W LEONARD ST, WATERTOWN, WI 53098-1710
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1079-154
WI
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881791556
CAROLYN AVERILL
WI
05
—
1881791556
—
WI
Enumeration date
09/17/2006
Last updated
07/12/2017
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