Individual
SUE CAVALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
2900 CURRY LN, GREEN BAY, WI 54311-5857
(920) 468-1161
Mailing address
2900 CURRY LN, GREEN BAY, WI 54311-5857
(920) 468-1161
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2195-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42789500
—
WI
Enumeration date
09/26/2006
Last updated
07/08/2007
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