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General NPI Number Information
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NPI Number | 1598689200
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Entity Type | Individual
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Provider Name | KAYLEE DEISBECK
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Gender | Female
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 3501 KINZIE AVE
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City | RACINE
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State | WI
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Zip | 53405-2438
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Country | US
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Telephone | 262-664-8150
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Fax |
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Provider Business Mailing Address
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Address Line | 8561 S VENTANA DR UNIT 4523
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City | OAK CREEK
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State | WI
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Zip | 53154-8343
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Country | US
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Telephone | 712-210-6501
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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 | 931948
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License Number State | WI
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