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
| License | State | Type | Specialty |
|---|---|---|---|
| 14301470 | WI | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in De Pere, 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 Mar 6, 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.