Healthcare Provider Details

I. General information

NPI: 1952790164
Provider Name (Legal Business Name): MICHELLE SKOIEN M.S., CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5790 S 27TH ST
MILWAUKEE WI
53221-4129
US

IV. Provider business mailing address

1304 E LAKE BLUFF BLVD
SHOREWOOD WI
53211-1536
US

V. Phone/Fax

Practice location:
  • Phone: 414-817-3720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4055-154
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: