Provider Demographics
NPI:1851648307
Name:KLAPPERICH, MAGGIE LANE
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:LANE
Last Name:KLAPPERICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:LANE
Other - Last Name:KLAPPERICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:6015 MOUNT RUSHMORE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-8984
Mailing Address - Country:US
Mailing Address - Phone:605-443-6164
Mailing Address - Fax:605-412-8021
Practice Address - Street 1:6015 MOUNT RUSHMORE RD STE 3
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-8984
Practice Address - Country:US
Practice Address - Phone:605-443-6164
Practice Address - Fax:605-412-8021
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD12119970235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist