Individual
MELODIE S WILLIHNGANZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS CLL A
Contact information
Practice address
130 WARREN ST, SUITE 211, BEAVER DAM, WI 53916-3062
(920) 887-0509
(920) 887-0518
Mailing address
819 GROVE ST, BEAVER DAM, WI 53916-1131
(920) 887-0407
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
238156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41129200
—
WI
Enumeration date
10/11/2005
Last updated
07/08/2007
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