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General NPI Number Information
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NPI Number | 1982275996
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Entity Type | Individual
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Provider Name | GINA SANFELIPPO CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 10950 W FOREST HOME AVE STE 14
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City | HALES CORNERS
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State | WI
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Zip | 53130-2556
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Country | US
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Telephone | 414-254-1420
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Fax |
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Provider Business Mailing Address
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Address Line | 4631 S PINE AVE
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City | MILWAUKEE
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State | WI
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Zip | 53207-5212
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Country | US
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Telephone | 414-254-1420
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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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