Amy E Banasik, SLP
Individual provider Active NPI Speech-Language Pathologist · Middleton, WI
NPI 1891458873 · NPPES record last updated Oct 18, 2021
Key facts
- NPI
- 1891458873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 5248-154 (WI)
- Practice address
- 6630 University Ave
Middleton, WI 53562-3036 - Phone
- (608) 263-8410
- Fax
- (608) 263-5011
- NPI assigned
- Oct 18, 2021
- 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 |
|---|---|---|---|
| 5248-154 | WI | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5248-154 | WI | Yes |
Addresses
Primary practice location
6630 University Ave
Middleton, WI 53562-3036
Mailing address
7974 Uw Health CT
Middleton, WI 53562-5531
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- Gwen Badger
- Rita T Bagga
- Alexia Grace Bales
- Brad E Baranowski
- Sharon A. Barger
- Christine Barney
- Neal P Barney
- Leah Barr
All providers in Middleton, 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 Oct 18, 2021. 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.