Individual
LEAH MARIE THEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFY-SLP MS
Contact information
Practice address
3821 KOHLER MEMORIAL DR, SUITE 102, SHEBOYGAN, WI 53081-3600
(920) 208-9648
Mailing address
1002 HAPPY LN, APARTMENT # 3, SHEBOYGAN FALLS, WI 53085-3428
(262) 751-3687
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3886-154
WI
Other
Enumeration date
09/10/2013
Last updated
09/10/2013
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