Healthcare Provider Details

I. General information

NPI: 1205762952
Provider Name (Legal Business Name): KAITLIN SOMPPI
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 CLOVER ST
WILLIAMS BAY WI
53191-9779
US

IV. Provider business mailing address

21855 W GREENFIELD AVE APT 1
NEW BERLIN WI
53146-1135
US

V. Phone/Fax

Practice location:
  • Phone: 262-245-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7411-154
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: