Alisa Garr

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

NPI 1780969428 · NPPES record last updated Oct 13, 2011

Key facts

NPI
1780969428
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
3555-154 (WI)
Practice address
1505 Orrin Rd
Prescott, WI 54021-1074
Phone
(715) 262-1107
NPI assigned
Oct 13, 2011
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
3555-154WIMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3555-154 WI Yes

Addresses

Primary practice location

1505 Orrin Rd
Prescott, WI 54021-1074

Mailing address

909 Holley Ave
St Paul Park, MN 55071-1419

Other providers in Prescott, WI

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

Sources for this page

Verify at the official NPI Registry.