Provider Demographics
NPI:1013634187
Name:REICHENBACH, CASSANDRA (MS/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:REICHENBACH
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:KEBBEKUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N9165 OAKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MUKWONAGO
Mailing Address - State:WI
Mailing Address - Zip Code:53149-1813
Mailing Address - Country:US
Mailing Address - Phone:414-324-6714
Mailing Address - Fax:608-535-6229
Practice Address - Street 1:6701 SEYBOLD RD STE 109
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1388
Practice Address - Country:US
Practice Address - Phone:608-571-2661
Practice Address - Fax:608-535-6229
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1221-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist