Provider Demographics
NPI:1164169793
Name:MANSKE, CLAIRE KATHRYN
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:KATHRYN
Last Name:MANSKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 N 76TH ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-3507
Mailing Address - Country:US
Mailing Address - Phone:414-379-6396
Mailing Address - Fax:
Practice Address - Street 1:411 PRAIRIE HEIGHTS DR STE 101
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-2238
Practice Address - Country:US
Practice Address - Phone:608-556-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist