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General NPI Number Information
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NPI Number | 1750200622
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Entity Type | Individual
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Provider Name | AMY LEE MATHWIG M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 145 W GREEN BAY ST
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City | PULASKI
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State | WI
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Zip | 54162-9350
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Country | US
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Telephone | 920-822-6118
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Fax |
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Provider Business Mailing Address
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Address Line | 737 BORDEAUX RUE
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City | GREEN BAY
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State | WI
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Zip | 54301-1454
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Country | US
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Telephone | 608-852-6366
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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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