Provider Demographics
NPI:1538372743
Name:STUDER, KAMI MARIE (MS/CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KAMI
Middle Name:MARIE
Last Name:STUDER
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:MISS
Other - First Name:KAMI
Other - Middle Name:MARIE
Other - Last Name:RIECHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS/CCC-SLP
Mailing Address - Street 1:W979 JUNEAU RD
Mailing Address - Street 2:
Mailing Address - City:PELL LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:53157
Mailing Address - Country:US
Mailing Address - Phone:262-279-7907
Mailing Address - Fax:
Practice Address - Street 1:905 E GENEVA ST
Practice Address - Street 2:
Practice Address - City:DELAVAN
Practice Address - State:WI
Practice Address - Zip Code:53115-1922
Practice Address - Country:US
Practice Address - Phone:262-728-1442
Practice Address - Fax:262-728-6693
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2263-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42580900Medicaid