Provider Demographics
NPI:1821136896
Name:REHSE, KATHRYN A (AUD)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:A
Last Name:REHSE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:A
Other - Last Name:BOOHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:40 SW 12TH ST
Mailing Address - Street 2:STE 201C
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-6521
Mailing Address - Country:US
Mailing Address - Phone:414-805-5587
Mailing Address - Fax:414-476-4701
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:AUDIOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-5587
Practice Address - Fax:414-476-4701
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2328231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1821136896Medicaid