Provider Demographics
NPI:1851692131
Name:ALTENHOFEN, NATALIE M (SLP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:ALTENHOFEN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 HOWLAND AVE
Mailing Address - Street 2:#100
Mailing Address - City:WESTON
Mailing Address - State:WI
Mailing Address - Zip Code:54476-5633
Mailing Address - Country:US
Mailing Address - Phone:715-355-5701
Mailing Address - Fax:715-359-9531
Practice Address - Street 1:3402 HOWLAND AVE
Practice Address - Street 2:#100
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476-5633
Practice Address - Country:US
Practice Address - Phone:715-355-5701
Practice Address - Fax:715-359-9531
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI348154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist