Healthcare Provider Details

I. General information

NPI: 1528714656
Provider Name (Legal Business Name): ALLISON MARIE BEHNKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON MARIE DORN

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 01/13/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 MEMORIAL DR
BERLIN WI
54923-1243
US

IV. Provider business mailing address

3 NEENAH CTR
NEENAH WI
54956-3070
US

V. Phone/Fax

Practice location:
  • Phone: 920-361-5534
  • Fax:
Mailing address:
  • Phone: 920-361-1313
  • Fax: 920-361-5910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5511
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: