Healthcare Provider Details

I. General information

NPI: 1083550271
Provider Name (Legal Business Name): SAMANTHA ACKERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 E HIGH ST
MILTON WI
53563-1502
US

IV. Provider business mailing address

4120 PARK VIEW DR
JANESVILLE WI
53546-1776
US

V. Phone/Fax

Practice location:
  • Phone: 608-868-9200
  • Fax:
Mailing address:
  • Phone: 262-949-1323
  • 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: