Sharon Therese Bonneau, MSCCCSLP
Individual provider Active NPI Speech-Language Pathologist · Menasha, WI
NPI 1205979523 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1205979523
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2708-154 (WI)
- Practice address
- 1800 Appleton Rd
Menasha, WI 54952-3727 - Phone
- (920) 968-6021
- Fax
- (920) 725-2572
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2708-154 | WI | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2708-154 | WI | Yes |
Addresses
Primary practice location
1800 Appleton Rd
Menasha, WI 54952-3727
Mailing address
3815 Stoney Creek CT
Appleton, WI 54913-7953
Phone (920) 731-5265
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2708-154 | Other | WI | WI LICENSE |
| 42572200 | Medicaid | WI |
Other providers in Menasha, WI
- Eric Blazel
- Suzanne C Bloomhuff
- Christine Boe
- Janine M. Boldra
- Rebecca Bollant
- Lisa C Boucher
- Lisa Bredael
- Rachel L Bresler
- John R Briggs
- Risa Briones
All providers in Menasha, 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 Jul 8, 2007. 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.