Provider Demographics
NPI:1245882505
Name:DEHN, GRETCHEN MARGARET (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:MARGARET
Last Name:DEHN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 S 31ST ST APT 401
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-1496
Mailing Address - Country:US
Mailing Address - Phone:402-650-9064
Mailing Address - Fax:
Practice Address - Street 1:7 N 6TH ST
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-0710
Practice Address - Country:US
Practice Address - Phone:402-650-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA088646235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist