Healthcare Provider Details

I. General information

NPI: 1932034188
Provider Name (Legal Business Name): MARISSA SCHAEFER AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 S STOUGHTON RD
MADISON WI
53716-2257
US

IV. Provider business mailing address

832 LINCOLN GREEN RD
DEFOREST WI
53532-1629
US

V. Phone/Fax

Practice location:
  • Phone: 608-260-6000
  • Fax:
Mailing address:
  • Phone: 920-254-5891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: