Healthcare Provider Details

I. General information

NPI: 1386573871
Provider Name (Legal Business Name): JOANNE LANDT PHD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S 35TH ST
MANITOWOC WI
54220-4299
US

IV. Provider business mailing address

8503 HERSHAU RD
REEDSVILLE WI
54230-8525
US

V. Phone/Fax

Practice location:
  • Phone: 920-663-9733
  • Fax:
Mailing address:
  • Phone: 920-652-4065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1590053757
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: