Healthcare Provider Details

I. General information

NPI: 1932015344
Provider Name (Legal Business Name): MICHAELA ANN DANIELS MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WISCONSIN ST
LAKE GENEVA WI
53147-1831
US

IV. Provider business mailing address

37950 91ST ST
TWIN LAKES WI
53181-9163
US

V. Phone/Fax

Practice location:
  • Phone: 262-348-4000
  • Fax:
Mailing address:
  • Phone: 262-716-4998
  • 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:
Title or Position:
Credential:
Phone: