=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043149115
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTEN LYNN SUNDLIN MS SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2026
-----------------------------------------------------
Last Update Date | 05/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 114 W HIGH ST
-----------------------------------------------------
City | MILTON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53563-1669
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-868-9300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 448 E HIGH ST
-----------------------------------------------------
City | MILTON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53563-1502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-868-9200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 1590044508
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------