Provider Demographics
NPI:1467805911
Name:DEROUCHEY, LONDA M (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LONDA
Middle Name:M
Last Name:DEROUCHEY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8226 S BLUCKSBERG MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:SD
Mailing Address - Zip Code:57785-2821
Mailing Address - Country:US
Mailing Address - Phone:605-347-0660
Mailing Address - Fax:
Practice Address - Street 1:8226 S BLUCKSBERG MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:SD
Practice Address - Zip Code:57785-2821
Practice Address - Country:US
Practice Address - Phone:605-720-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP12665235Z00000X
ND1892235Z00000X
SD581-SLP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist