Organization
MILWAUKEE SPEECH AND MEMORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN LARSON MS-SLP (OWNER)
(708) 819-1885
Entity
Organization
Contact information
Practice address
3929 N FARWELL AVE, SHOREWOOD, WI 53211-2412
(708) 819-1885
Mailing address
3929 N FARWELL AVE, SHOREWOOD, WI 53211-2412
(708) 819-1885
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770810756
—
WI
Enumeration date
06/03/2022
Last updated
08/05/2022
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