Healthcare Provider Details

I. General information

NPI: 1912810359
Provider Name (Legal Business Name): SUNRISE SPEECH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 E 5TH AVE
BRODHEAD WI
53520-1144
US

IV. Provider business mailing address

604 E 5TH AVE
BRODHEAD WI
53520-1144
US

V. Phone/Fax

Practice location:
  • Phone: 608-897-6727
  • Fax:
Mailing address:
  • Phone: 608-897-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SAVANNAH BAADE
Title or Position: SPEECH-LANGUAGE PATHOLOGIST/OWNER
Credential: CCC-SLP
Phone: 608-897-6727