Provider Demographics
NPI:1851085906
Name:WOLOSEK-RAATZ, ASHLEY BETH
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:BETH
Last Name:WOLOSEK-RAATZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 W MAIN ST APT 354
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-3039
Mailing Address - Country:US
Mailing Address - Phone:754-595-5593
Mailing Address - Fax:
Practice Address - Street 1:1223 MADISON ST
Practice Address - Street 2:
Practice Address - City:BEAVER DAM
Practice Address - State:WI
Practice Address - Zip Code:53916-2629
Practice Address - Country:US
Practice Address - Phone:920-885-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6208-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist