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Individual

GENNINE CASTANEDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS CCC SLP

Contact information

Practice address
3401 MAPLE GROVE DR, MADISON, WI 53719-5013
(608) 845-1000
(608) 845-1001
Mailing address
6405 PIZARRO CIR, MADISON, WI 53719-1893
(608) 848-7332

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1980-154
WI
314000000X
Skilled Nursing Facility
1980 154
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42783300
WI
Enumeration date
01/24/2007
Last updated
11/05/2015
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