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General NPI Number Information
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NPI Number | 1720917180
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Entity Type | Individual
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Provider Name | IRINA ANDREYEVNA KHITSUN M.S. CCC-SLP
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Gender |
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 5602 RUSSETT RD
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City | MADISON
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State | WI
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Zip | 53711-3568
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Country | US
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Telephone | 608-334-7927
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Fax |
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Provider Business Mailing Address
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Address Line | 5602 RUSSETT RD
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City | MADISON
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State | WI
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Zip | 53711-3568
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Country | US
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Telephone |
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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 | WI
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