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General NPI Number Information
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NPI Number | 1639063423
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Entity Type | Individual
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Provider Name | MICHELLE ROSE GASPER
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Gender | Female
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 3620 WILGUS AVE
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City | SHEBOYGAN
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State | WI
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Zip | 53081-3068
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Country | US
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Telephone | 920-208-9648
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Fax |
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Provider Business Mailing Address
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Address Line | N101W14353 HUCKLEBERRY CT
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City | GERMANTOWN
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State | WI
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Zip | 53022-5389
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Country | US
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Telephone | 262-744-4920
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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 |
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License Number State |
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