Healthcare Provider Details
I. General information
NPI: 1861310948
Provider Name (Legal Business Name): ELLA FAWCETT ALDRIDGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 OVERLOOK TER
MADISON WI
53705-2254
US
IV. Provider business mailing address
1707 REETZ RD
MADISON WI
53711-3652
US
V. Phone/Fax
- Phone: 608-256-1901
- Fax:
- Phone: 815-312-7298
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: