Provider Demographics
NPI:1730823204
Name:SOGGE, ALYSSA M (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:M
Last Name:SOGGE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:ALYSSA
Other - Middle Name:M
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:1000 MINERAL POINT AVE
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2982
Mailing Address - Country:US
Mailing Address - Phone:608-756-6868
Mailing Address - Fax:608-756-6289
Practice Address - Street 1:1000 MINERAL POINT AVE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2982
Practice Address - Country:US
Practice Address - Phone:608-756-6868
Practice Address - Fax:608-756-6289
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5496-154235Z00000X
ND1851235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100208689Medicaid