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NPI Code Detail

MEDICARE: CHLOE CUSACK MS SLP-CFY

MEDICARE: CHLOE CUSACK MS SLP-CFY
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 Pathologist5257154WI

General Provider Information

NPI Number : 1437727534
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHLOE CUSACK MS SLP-CFY
Provider Business Mailing Address
First Line : 19395 W CAPITOL DR STE 200
Second Line :
City : BROOKFIELD
State : WI
Zip : 53045-2736
Country : US
Telephone Number : 262-923-7101
Fax Number : 262-923-7178
Provider Business Practice Location Address
First Line : 620 SCHOENHAAR DR
Second Line :
City : WEST BEND
State : WI
Zip : 53090-2649
Country : US
Telephone Number : 262-306-8450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2021
Last Update Date : 06/15/2021

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Directions to “ CHLOE CUSACK MS SLP-CFY” Practice Location

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