Provider Demographics
NPI:1801092994
Name:KLOSTER, DEBRA SUE
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:SUE
Last Name:KLOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 DOWNING AVE
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-6031
Mailing Address - Country:US
Mailing Address - Phone:319-493-9222
Mailing Address - Fax:888-443-8173
Practice Address - Street 1:1835 DOWNING AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-6031
Practice Address - Country:US
Practice Address - Phone:319-493-9222
Practice Address - Fax:888-443-8173
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2009-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIA00861237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist