Provider Demographics
NPI:1346417128
Name:REESE, AARON L (SLP)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:L
Last Name:REESE
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 CADDIS BND
Mailing Address - Street 2:#102
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-7139
Mailing Address - Country:US
Mailing Address - Phone:608-695-7993
Mailing Address - Fax:
Practice Address - Street 1:110 BELMONT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-3129
Practice Address - Country:US
Practice Address - Phone:608-249-7391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2810-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42583400Medicaid