Provider Demographics
NPI:1215037213
Name:STOPPENBACH, DANIEL T (MS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:T
Last Name:STOPPENBACH
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53706-1103
Mailing Address - Country:US
Mailing Address - Phone:608-262-3951
Mailing Address - Fax:
Practice Address - Street 1:1975 WILLOW DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53706-1103
Practice Address - Country:US
Practice Address - Phone:608-262-3951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI48-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist