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NPI Code Detail

MEDICARE: KAYLEIGH JO SEBBEN

MEDICARE: KAYLEIGH JO SEBBEN
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 PathologistWI

General Provider Information

NPI Number : 1790615516
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEIGH JO SEBBEN
Provider Business Mailing Address
First Line : 2200 NICOLET DR APT 9
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-7453
Country : US
Telephone Number : 309-337-3540
Fax Number :
Provider Business Practice Location Address
First Line : 200 S BROADWAY
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-1516
Country : US
Telephone Number : 920-448-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2026
Last Update Date : 05/22/2026

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Directions to “ KAYLEIGH JO SEBBEN ” Practice Location

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