Provider Demographics
NPI:1326726274
Name:SPEECH QUEST
Entity Type:Organization
Organization Name:SPEECH QUEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HENNES
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:414-687-0767
Mailing Address - Street 1:3202 BARK LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HUBERTUS
Mailing Address - State:WI
Mailing Address - Zip Code:53033-9693
Mailing Address - Country:US
Mailing Address - Phone:414-687-0767
Mailing Address - Fax:
Practice Address - Street 1:3202 BARK LAKE RD
Practice Address - Street 2:
Practice Address - City:HUBERTUS
Practice Address - State:WI
Practice Address - Zip Code:53033-9693
Practice Address - Country:US
Practice Address - Phone:414-687-0767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty