Provider Demographics
NPI:1922779198
Name:DETERS, VELMA
Entity Type:Individual
Prefix:
First Name:VELMA
Middle Name:
Last Name:DETERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:
Other - Last Name:DETERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:150 S 5TH ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-4223
Mailing Address - Country:US
Mailing Address - Phone:763-268-4286
Mailing Address - Fax:
Practice Address - Street 1:956 DAWSONVILLE HWY STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2615
Practice Address - Country:US
Practice Address - Phone:770-536-5552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist