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NPI Code Detail

MEDICARE: MRS. KARLA RENAE RETRUM MS, CCC-SLP

MEDICARE:  MRS. KARLA RENAE RETRUM  MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistWI

General Provider Information

NPI Number : 1376930560
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KARLA RENAE RETRUM MS, CCC-SLP
Provider Business Mailing Address
First Line : 4510 FOREST VALLEY RD
Second Line :
City : WAUSAU
State : WI
Zip : 54403-1104
Country : US
Telephone Number : 715-551-9281
Fax Number :
Provider Business Practice Location Address
First Line : 4510 FOREST VALLEY RD
Second Line :
City : WAUSAU
State : WI
Zip : 54403-1104
Country : US
Telephone Number : 715-802-0474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2015
Last Update Date : 07/05/2023

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Directions to “ MRS. KARLA RENAE RETRUM MS, CCC-SLP” Practice Location

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