Organization
EPHPHATHA TINY MOUTH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET SCHUMAKER CCC-SLP (OWNER)
(262) 483-6597
Entity
Organization
Contact information
Practice address
490 W ROLLING MEADOWS DR, FOND DU LAC, WI 54937-8624
(262) 483-6597
Mailing address
9565 BOLTONVILLE RD, KEWASKUM, WI 53040-9730
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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