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General NPI Number Information
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NPI Number | 1497956874
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Entity Type | Individual
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Provider Name | SUSAN DIANE MICHLER MS CCC SLP
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 7269 HIGHWAY 60
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City | CEDARBURG
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State | WI
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Zip | 53012
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Country | US
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Telephone | 262-377-8350
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Fax |
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Provider Business Mailing Address
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Address Line | 296 LAUREL LN
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City | FOND DU LAC
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State | WI
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Zip | 54935-5372
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Country | US
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Telephone | 920-922-1272
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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 | 1504-154
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License Number State | WI
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