Individual provider Active NPI

Mollie Hartwig, SLP

  • Speech-Language Pathologist
  • Peshtigo, WI
National Provider Identifier
1437430204
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3535-154 Issued in WI
Practice address
701 Willow St
Peshtigo, WI 54157-1165
Phone
(715) 582-3962
Fax
(715) 582-0803
NPI assigned
Sep 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3535-154 WI Primary

Addresses

Primary practice location

701 Willow St
Peshtigo, WI 54157-1165

Mailing address

1713 Dunlap Ave Apt 309
Marinette, WI 54143
Phone (715) 571-2330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3535-154WIMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1437430204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 DUNLAP AVE APT 309",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "54143",
            "telephone_number": "715-571-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WILLOW ST",
            "city": "PESHTIGO",
            "state": "WI",
            "postal_code": "541571165",
            "telephone_number": "715-582-3962",
            "fax_number": "715-582-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTWIG",
        "first_name": "MOLLIE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3535-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peshtigo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.