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General NPI Number Information
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NPI Number | 1598078644
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Entity Type | Individual
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Provider Name | THEA NEUMANN M.A., CCC-SLP/L
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Gender | Female
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | 3117 SHORE DR SUITE 101
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City | MARINETTE
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State | WI
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Zip | 54143-4293
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Country | US
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Telephone | 715-735-4200
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Fax |
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Provider Business Mailing Address
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Address Line | N12080 ALLISON LN
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City | SILVER CLIFF
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State | WI
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Zip | 54104-9411
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Country | US
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Telephone | 630-292-4104
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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 | 3400-154
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License Number State | WI
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