Anita Lee-Bjerke
Individual provider Active NPI Speech-Language Pathologist · Omro, WI
NPI 1891196374 · NPPES record last updated Sep 15, 2014
Key facts
- NPI
- 1891196374
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 4016-154 (WI)
- Practice address
- 500 Grant Ave
Omro, WI 54963-1342 - Phone
- (920) 859-0269
- Fax
- (920) 859-0279
- NPI assigned
- Sep 15, 2014
- 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 |
|---|---|---|---|
| 4016-154 | WI | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4016-154 | WI | Yes |
Addresses
Primary practice location
500 Grant Ave
Omro, WI 54963-1342
Mailing address
1033 N Lark St
Oshkosh, WI 54902-3349
Phone (920) 859-0269
Other providers in Omro, WI
- Emily Klawitter
- Mitchell David Kramer
- Douglas Langeberg
- Alyson P Larson
- Jennie Laue
- Thomas Robert Machak
- Kelly L McCormick
- Rachel L McInnis
- MDC Omro, S.C.
- Chad Meyer
All providers in Omro, 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 Sep 15, 2014. 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.