1346314341

Everything you always wanted to know about MRS. ORHEIM ELLEN GWEN MS CCCSLP 1 MISS HOVEY ELLEN GWEN MS CCCSLP but were afraid to ask.

MRS. ORHEIM ELLEN GWEN MS CCCSLP 1 MISS HOVEY ELLEN GWEN MS CCCSLP

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Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential Provider Other Name Type Code Provider Other Name Prefix Provider Other Last Name Provider Other Middle Name Provider Other First Name Provider Other Credential
MRS. ORHEIM ELLEN GWEN MS CCCSLP 1 MISS HOVEY ELLEN GWEN MS CCCSLP
Gender:
Female
Enumeration date:
2006-11-20
Last update date:
2007-11-14
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state
1491-154 Other STATE LICENSURE WI
425-886-00 Medicaid none WI
01109878 Other ASHA WI

Taxonomies

Taxonomy State License Number Primary?
2355S0801X Speech-Language Assistant WI 1491-154

Phone Numbers

Type Number
Mailing Address Telephone Number 4148589223
Practice Location Address Telephone Number 4148589223
Mailing Address Fax Number 4148581017
Practice Location Address Fax Number 4148581017

Addresses

Type Address City State Postal Country
Mailing Address 10500 W LOOMIS RD SUITE 150 FRANKLIN WI 0 WI
Practice Location Address 10500 W LOOMIS RD SUITE 150 FRANKLIN WI 0 WI

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10500 W LOOMIS RD STE 150 WI FRANKLIN
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1053387498 NORDYKE, GARY
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1396921714 SPORTS MEDICINE & ORTHOPEDIC C
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1740319680 SCHACHT, WILLIAM
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1861441693 ONG, SENG
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1962774992 VICARI, SARAH
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1982714275 CARPITA-ELMER, ROSANNA
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10500 W LOOMIS RD WI FRANKLIN