Provider Demographics
NPI:1629270012
Name:GEIGER, SADIE LYNN (MS CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:SADIE
Middle Name:LYNN
Last Name:GEIGER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 W LINDBERGH ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-2334
Mailing Address - Country:US
Mailing Address - Phone:920-901-5101
Mailing Address - Fax:
Practice Address - Street 1:125 BYRD AVE
Practice Address - Street 2:VALLHAVEN CARE CENTER
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956
Practice Address - Country:US
Practice Address - Phone:920-725-7869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2506154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42802800Medicaid