Facts
- Status
- A
- Credential
- M.S. CCC-SLP
- Type
- Individual
- Enumeration date
- 2011-06-13
- Last updated
- 2018-06-12
Specialties
Licenses
- License MN
- Number not in the file
Location
- Practice location
- 265 GRIFFIN ST E
- City
- AMERY WI
- Postal code
- 540011439
- Phone
- 715-268-8000
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.