Mialee Ambrose
Individual provider Active NPI Speech-Language Pathologist · Lake Geneva, WI
NPI 1992418149 · NPPES record last updated Jan 3, 2023
Key facts
- NPI
- 1992418149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 700 Geneva Pkwy N
Lake Geneva, WI 53147-4594 - Phone
- (262) 249-3500
- NPI assigned
- Jan 3, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | WI | Yes |
Addresses
Primary practice location
700 Geneva Pkwy N
Lake Geneva, WI 53147-4594
Mailing address
700 Geneva Pkwy N
Lake Geneva, WI 53147-4594
Other providers in Lake Geneva, WI
- Annapurna Adiga
- Advanced Eyecare & Contact Lens Center, LLC
- Aya Akram Al-Anani
- Nestor C Alabarca
- Zachary P Allegretti
- Judith Ellen Anderson Mayer
- Katharine Renee Anderson
- Mary Elizabeth Anderson
- Matthew Scott Anderson
- Nancy S Asencio
All providers in Lake Geneva, 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 Jan 3, 2023. 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.