Healthcare Provider Details

I. General information

NPI: 1659237303
Provider Name (Legal Business Name): MACEY ELIZABETH MOSER M.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2025
Last Update Date: 12/27/2025
Certification Date: 12/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6902 PARKSIDE CIR
DEFOREST WI
53532-2560
US

IV. Provider business mailing address

8570 GREENWAY BLVD APT 410
MIDDLETON WI
53562-4741
US

V. Phone/Fax

Practice location:
  • Phone: 608-846-2101
  • Fax:
Mailing address:
  • Phone: 608-338-2364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: