Provider Demographics
NPI:1578080495
Name:DELROSARIO, DON (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:
Last Name:DELROSARIO
Suffix:
Gender:M
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MACON R-1 SCHOOLS
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:MO
Mailing Address - Zip Code:63552
Mailing Address - Country:US
Mailing Address - Phone:660-385-2118
Mailing Address - Fax:
Practice Address - Street 1:702 N MISSOURI ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:MO
Practice Address - Zip Code:63552-2062
Practice Address - Country:US
Practice Address - Phone:660-385-2118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist