MEDICARE: MILWAUKEE BILINGUAL SPEECH/LANGUAGE PATHOLOGISTS, LLC

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	251E00000X	Home Health Agency	2798-154	WI
2	261QH0700X	Hearing and Speech Clinic/Center	2798-154	WI

General Provider Information

NPI Number	:	1528447778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILWAUKEE BILINGUAL SPEECH/LANGUAGE PATHOLOGISTS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 342507
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53234-2507
Country	:	US
Telephone Number	:	414-326-8689
Fax Number	:

Provider Business Practice Location Address
First Line	:	2532 N NEWHALL ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-3964
Country	:	US
Telephone Number	:	414-326-8689
Fax Number	:

Authorized Official
Title or Position	:	MEMBER/PARTNER/OWNER
Name	:	HOLLY M DELGADO
Credential	:	M.A.
Telephone Number	:	414-326-8689

Provider Enumeration Date	:	05/20/2015
Last Update Date	:	05/20/2015

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