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General NPI Number Information
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NPI Number | 1083779607
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Entity Type | Individual
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Provider Name | MILAGROS CACERES
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Gender | Female
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 12600 PT. WASHINGTON RD NEWCASTLE PLACE
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City | MEQUON
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State | WI
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Zip | 53092-3469
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Country | US
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Telephone | 262-387-8800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 170441
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City | MILWAUKEE
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State | WI
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Zip | 53217-8036
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 681-154
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License Number State | WI
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