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General NPI Number Information
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NPI Number | 1104036409
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Entity Type | Individual
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Provider Name | KATHRYN ANNE BRUFLAT MS-CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 321 RIVERSIDE DR
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City | PEWAUKEE
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State | WI
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Zip | 53072-4612
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Country | US
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Telephone | 262-691-2300
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Fax | 262-691-6256
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Provider Business Mailing Address
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Address Line | W330N6264 HASSLINGER DR
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City | NASHOTAH
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State | WI
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Zip | 53058-9732
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Country | US
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Telephone | 262-691-6262
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Fax | 262-691-6256
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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 | 889-154
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License Number State | WI
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