Individual
MRS. INGRID ANN FREITAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1040 PILGRIM WAY, GREEN BAY, WI 54304-5028
(920) 405-3522
Mailing address
3948 GARRETT ST, DE PERE, WI 54115-1650
(920) 338-0474
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2596-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42586000
—
WI
Enumeration date
11/13/2008
Last updated
03/06/2012
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