Healthcare Provider Details

I. General information

NPI: 1538073135
Provider Name (Legal Business Name): AMY M GRAFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

346 W RANDOLPH ST
ROSHOLT WI
54473-9547
US

IV. Provider business mailing address

346 W RANDOLPH ST
ROSHOLT WI
54473-9547
US

V. Phone/Fax

Practice location:
  • Phone: 715-677-4541
  • Fax: 715-304-4856
Mailing address:
  • Phone: 715-677-4541
  • Fax: 715-304-4856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberF420$$$$$$$$$
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: