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General NPI Number Information
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NPI Number | 1386581346
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Entity Type | Organization
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Legal Business Name | GREEN BAY PEDIATRIC THERAPY, LLC
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 981 SOUTHERN CROSS RD
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City | GREEN BAY
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State | WI
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Zip | 54303-6500
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Country | US
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Telephone | 920-241-6707
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Fax |
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Provider Business Mailing Address
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Address Line | 981 SOUTHERN CROSS RD
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City | GREEN BAY
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State | WI
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Zip | 54303-6500
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Country | US
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Telephone | 920-241-6707
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST/OWNER
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Name | HANNAH WESOLOWSKI
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Credential | M.S., CCC-SLP
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Telephone | 920-241-6707
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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 |
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License Number State |
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