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NPI Code Detail

MEDICARE: CASSIE JO M DREWIESKE

MEDICARE: CASSIE JO M DREWIESKE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist3466-154WI

General Provider Information

NPI Number : 1811291792
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSIE JO M DREWIESKE
Provider Business Mailing Address
First Line : 1609 N PROSPECT AVE
Second Line : #804
City : MILWAUKEE
State : WI
Zip : 53202-2492
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1616 W BENDER RD
Second Line :
City : GLENDALE
State : WI
Zip : 53209-3802
Country : US
Telephone Number : 414-228-8700
Fax Number : 414-228-9946
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2011
Last Update Date : 01/06/2011

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Directions to “ CASSIE JO M DREWIESKE ” Practice Location

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