Provider Demographics
NPI:1598960122
Name:DELCAU, ROXANNE MARIE (EDD)
Entity type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:MARIE
Last Name:DELCAU
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 STONEY MEADOWS DR
Mailing Address - Street 2:APT. E.
Mailing Address - City:VALLEY PARK
Mailing Address - State:MO
Mailing Address - Zip Code:63088-1228
Mailing Address - Country:US
Mailing Address - Phone:636-529-1320
Mailing Address - Fax:
Practice Address - Street 1:6768 N US HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-2742
Practice Address - Country:US
Practice Address - Phone:314-741-9101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00749235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist