Individual
KATIE IVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
702 W DOLF ST, COLBY, WI 54421-9604
(715) 223-2352
Mailing address
1008 LANDFRIED AVE, MOSINEE, WI 54455-1525
(715) 821-9220
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3016-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992991756
—
WI
Enumeration date
09/14/2007
Last updated
10/18/2012
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