MEDICARE: CARLY MUELLER

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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1316832934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY MUELLER

Provider Business Mailing Address
First Line	:	535 PARKVIEW DR
Second Line	:
City	:	MILTON
State	:	WI
Zip	:	53563-1710
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 S ATWOOD AVE
Second Line	:
City	:	JANESVILLE
State	:	WI
Zip	:	53545-4098
Country	:	US
Telephone Number	:	608-752-6709
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2025
Last Update Date	:	06/12/2025

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Directions to “ CARLY MUELLER ” Practice Location

Language	Start Address	Practice Location

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