Provider Demographics
NPI:1790263804
Name:EMME, KATE HENNIGES (SLP)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:HENNIGES
Last Name:EMME
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:L
Other - Last Name:HENNIGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:PO BOX 22487
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54305-2487
Mailing Address - Country:US
Mailing Address - Phone:920-445-7222
Mailing Address - Fax:920-445-7289
Practice Address - Street 1:744 S WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-3505
Practice Address - Country:US
Practice Address - Phone:920-433-7822
Practice Address - Fax:920-433-3651
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4273-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist