Individual
MIKAILA FAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, SLP-CCC
Contact information
Practice address
CEREBRAL PALSY, INC, 2801 S WEBSTER AVE, GREEN BAY, WI 54301
(920) 337-1122
(920) 337-1121
Mailing address
CEREBRAL PALSY, INC, 2801 S WEBSTER AVE, GREEN BAY, WI 54301
(920) 337-1121
(920) 337-1126
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5262-154
WI
235Z00000X
Speech-Language Pathologist
—
WI
Other
Enumeration date
05/21/2021
Last updated
11/17/2022
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