Healthcare Provider Details

I. General information

NPI: 1629908173
Provider Name (Legal Business Name): ALISSA SCHMIDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

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

30 S WISCONSIN AVE
RICE LAKE WI
54868-1927
US

IV. Provider business mailing address

30 S WISCONSIN AVE
RICE LAKE WI
54868-1927
US

V. Phone/Fax

Practice location:
  • Phone: 715-579-7504
  • Fax:
Mailing address:
  • Phone: 715-234-2181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number695306
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: