Provider Demographics
NPI:1114631686
Name:DUBUQUE SPEECH SOLUTIONS PLLC
Entity Type:Organization
Organization Name:DUBUQUE SPEECH SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:PANCRATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:563-495-0335
Mailing Address - Street 1:1470 TOWER DR APT 3
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-8079
Mailing Address - Country:US
Mailing Address - Phone:156-349-5033
Mailing Address - Fax:
Practice Address - Street 1:1470 TOWER DR APT 3
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52003-8079
Practice Address - Country:US
Practice Address - Phone:563-495-0335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty