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NPI Code Detail

MEDICARE: ELLEN SMITH

MEDICARE:   ELLEN  SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1295668259
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN SMITH
Provider Business Mailing Address
First Line : W220N6151 TOWN LINE RD
Second Line :
City : SUSSEX
State : WI
Zip : 53089-3923
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : W220N6151 TOWN LINE RD
Second Line :
City : SUSSEX
State : WI
Zip : 53089-3923
Country : US
Telephone Number : 262-246-6471
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ ELLEN SMITH ” Practice Location

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