Provider Demographics
NPI:1861727562
Name:AUSSEM, JOSEPH DANIEL (AUD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DANIEL
Last Name:AUSSEM
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 W GOOD HOPE RD UNIT 144
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-2749
Mailing Address - Country:US
Mailing Address - Phone:414-731-9341
Mailing Address - Fax:
Practice Address - Street 1:2300 W GOOD HOPE RD UNIT 144
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-2749
Practice Address - Country:US
Practice Address - Phone:414-731-9341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI534-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist