Melissa Kietzman
Individual provider Active NPI Speech-Language Pathologist · Waunakee, WI
NPI 1104750439 · NPPES record last updated Jun 11, 2026
Key facts
- NPI
- 1104750439
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 1590015724 (WI)
- Practice address
- 6271 Woodland Dr
Waunakee, WI 53597-9256 - Phone
- (608) 849-2030
- NPI assigned
- Jun 11, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1590015724 | WI | Yes |
Addresses
Primary practice location
6271 Woodland Dr
Waunakee, WI 53597-9256
Mailing address
5085 Vienna Dr
Waunakee, WI 53597-9747
Phone (608) 225-4796
Other providers in Waunakee, WI
- Matthew Karls
- Shari L. Karls
- Stanley A Karls
- Alison Kavelaris
- Sami Kawas
- Ana Killean
- Brooke M.B. Kinney
- Morgan Klein
- Kristen L Knox
- Cheryl Koelling
All providers in Waunakee, WI · Speech-Language Pathologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.