Thomas David Petersen, MSCCCSLP

Speech-Language Pathologist · Delavan, WI

Individual Active NPI

NPI number 1134249246

Practice location

N4901 Dam Rd
Delavan, WI 53115-2927
Phone
(262) 740-2170
Fax
(262) 740-7201

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NPI record

NPI
1134249246
Entity type
Individual (Type 1)
Enumeration date
March 30, 2007
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Speech-Language Pathologist Primary 235Z00000X 2444154 WI

About Thomas Petersen

Thomas David Petersen, MSCCCSLP is a healthcare provider registered in the NPI registry with the primary taxonomy Speech-Language Pathologist (code 235Z00000X). The practice location is N4901 Dam Rd, Delavan, WI 53115-2927. The NPI number 1134249246 was assigned on March 30, 2007 and the record was last updated on July 8, 2007.

Thomas Petersen lists a license in the registry: #2444154 (WI) for Speech-Language Pathologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Thomas David Petersen, MSCCCSLP?

The NPI number is 1134249246.

What is the phone number of Thomas Petersen?

The phone number listed for the practice location is (262) 740-2170.

Where is Thomas Petersen located?

N4901 Dam Rd, Delavan, WI 53115-2927.

What is the taxonomy code for Thomas Petersen?

The primary taxonomy code is 235Z00000X – Speech-Language Pathologist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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