Jordan Angst

Individual provider Active NPI Speech-Language Pathologist · De Pere, WI

NPI 1386590982 · NPPES record last updated Mar 6, 2026

Key facts

NPI
1386590982
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
14301470 (WI)
Practice address
1900 Williams Grant Dr
De Pere, WI 54115-9574
Phone
(920) 425-1900
NPI assigned
Mar 6, 2026
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

LicenseStateTypeSpecialty
14301470WIMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 14301470 WI Yes

Addresses

Primary practice location

1900 Williams Grant Dr
De Pere, WI 54115-9574

Mailing address

2039 Bracton Rd
Suamico, WI 54313-3700
Phone (920) 264-6632

Other providers in De Pere, WI

All providers in De Pere, WI · Speech-Language Pathologist in Wisconsin

Sources for this page

Verify at the official NPI Registry.