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NPI Code Detail

MEDICARE: MRS. EWA MALGORZATA MCLEAN M.S., CCC-SLP

MEDICARE: MRS. EWA MALGORZATA MCLEAN M.S., CCC-SLP
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 PathologistSP-1087NV
2235Z00000XSpeech-Language Pathologist6085-154WI

General Provider Information

NPI Number : 1689833311
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EWA MALGORZATA MCLEAN M.S., CCC-SLP
Provider Business Mailing Address
First Line : PO BOX 22487
Second Line :
City : GREEN BAY
State : WI
Zip : 54305-2487
Country : US
Telephone Number : 920-445-7210
Fax Number : 920-445-7289
Provider Business Practice Location Address
First Line : 744 S WEBSTER AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-3581
Country : US
Telephone Number : 920-433-7822
Fax Number : 920-433-3651
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2008
Last Update Date : 04/07/2023

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