Provider Demographics
NPI:1154566099
Name:FEAKES, DARREL RAY (AUD)
Entity type:Individual
Prefix:DR
First Name:DARREL
Middle Name:RAY
Last Name:FEAKES
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 W LOOMIS RD
Mailing Address - Street 2:SUITE #221
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8887
Mailing Address - Country:US
Mailing Address - Phone:414-529-9330
Mailing Address - Fax:414-529-9331
Practice Address - Street 1:9200 W LOOMIS RD
Practice Address - Street 2:SUITE #221
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8887
Practice Address - Country:US
Practice Address - Phone:414-529-9330
Practice Address - Fax:414-529-9331
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI342156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist