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General NPI Number Information
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NPI Number | 1336926781
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Entity Type | Individual
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Provider Name | DEIRDRE ANN WELLS MS, EDD, CCC
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Gender | Female
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 725 W PARK AVE
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729-3399
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Country | US
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Telephone | 715-723-0341
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Fax |
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Provider Business Mailing Address
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Address Line | W7544 BUCKETS LN
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City | MEDFORD
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State | WI
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Zip | 54451-8892
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Country | US
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Telephone | 651-783-2368
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 673-154
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License Number State | WI
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