Provider Demographics
NPI:1417120791
Name:DUMMEYER-SAVINO, MARY BETH (MS)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:BETH
Last Name:DUMMEYER-SAVINO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 DELAWARE BLVD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-1749
Mailing Address - Country:US
Mailing Address - Phone:608-241-4583
Mailing Address - Fax:
Practice Address - Street 1:1201 DELAWARE BLVD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-1749
Practice Address - Country:US
Practice Address - Phone:608-241-4583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI682-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42669900Medicaid