Madonna Celeste Carr

Individual provider Active NPI Speech-Language Pathologist · Burlington, WI

NPI 1609216035 · NPPES record last updated Jun 29, 2013

Key facts

NPI
1609216035
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
3807-154 (WI)
Practice address
372 W Chestnut St
Burlington, WI 53105-1147
Phone
(773) 960-5529
NPI assigned
Jun 29, 2013
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

State licenses

LicenseStateTypeSpecialty
3807-154WIMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3807-154 WI Yes

Addresses

Primary practice location

372 W Chestnut St
Burlington, WI 53105-1147

Mailing address

372 W Chestnut St
Burlington, WI 53105-1147
Phone (773) 960-5529

Other providers in Burlington, WI

All providers in Burlington, WI · Speech-Language Pathologist in Wisconsin

Sources for this page

Verify at the official NPI Registry.