Individual provider · NPI-1

Becky Derosia

Speech-Language Pathologist, · Racine, WI

NPI number1487588257
StatusActive
Last updated in NPPESJun 9, 2026

Details

NPI
1487588257
Entity type
Individual (NPI-1)
Name
Becky Derosia
Sole proprietor
No
Enumeration date
Jun 9, 2026
Certification date
Jun 9, 2026
Last updated
Jun 9, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,1590066924WIYes

Practice location

8332 Northwestern Ave
Racine, WI 53406-1722

Phone 262-619-4578

Mailing address

8332 Northwestern Ave
Racine, WI 53406-1722

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