Regina Lederle Behnke, MS, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Glendale, WI
NPI 1265611008 · NPPES record last updated Oct 29, 2007
Key facts
- NPI
- 1265611008
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2299-154 (WI)
- Practice address
- 1633 W Bender Rd
Glendale, WI 53209-3801 - Phone
- (262) 241-6846
- Fax
- (414) 228-6320
- NPI assigned
- Oct 29, 2007
- 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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2299-154 | WI | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2299-154 | WI | Yes |
Addresses
Primary practice location
1633 W Bender Rd
Glendale, WI 53209-3801
Mailing address
5416 N Shasta Dr
Glendale, WI 53209-4923
Phone (414) 578-2610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42793700 | Medicaid | WI |
Other providers in Glendale, WI
- Michelle Kristie Beahm
- John C Becherer
- Darlene Collins Beck
- Bedrock HCS at Glendale LLC
- Behavioral Phyisical Therapy, Wellness & Home Care Center LLC
- Megan Ruth Beier
- Kashes Bender
- Lisa Suzanne-Poss Benson
- Kenneth C Berg
- Steven R Bergquist
All providers in Glendale, 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 Oct 29, 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.