Healthcare Provider Details

I. General information

NPI: 1679496558
Provider Name (Legal Business Name): ALLISYN KLEUTSCH-PALMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 SAEMANN AVE
SHEBOYGAN WI
53081-1957
US

IV. Provider business mailing address

3901 HEATHER VALLEY RD UNIT E-106
SHEBOYGAN WI
53083-6052
US

V. Phone/Fax

Practice location:
  • Phone: 715-661-2229
  • Fax:
Mailing address:
  • Phone: 715-661-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1144-156
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: