Healthcare Provider Details

I. General information

NPI: 1992615058
Provider Name (Legal Business Name): ELENA BUSALACCHI MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 W EDEN PL
MILWAUKEE WI
53220-1335
US

IV. Provider business mailing address

3737 S 56TH ST
GREENFIELD WI
53220-2046
US

V. Phone/Fax

Practice location:
  • Phone: 414-604-7900
  • Fax:
Mailing address:
  • Phone:
  • 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: