Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Thomas David Petersen, MSCCCSLP

Individual provider Speech-Language Pathologist · NPI 1134249246

Mr. Thomas David Petersen, MSCCCSLP is a Speech-Language Pathologist in Delavan, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2007.

Licensed in
WI
In the registry since
2007
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Practice location Address checks out

N4901 Dam Rd
Delavan, WI 53115-2927
Phone: (262) 740-2170
Fax: (262) 740-7201
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 2444154 (WI)

Record details

NPI number1134249246
Entity typeIndividual (Type 1)
GenderMale
Credentials MSCCCSLP
Sole proprietorNo
NPI enumeratedMarch 30, 2007
Last updated in NPPESJuly 8, 2007
Mailing addressN4901 Dam Rd, Delavan, WI 53115-2927

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