Provider Demographics
NPI:1023871456
Name:SUNNY SPEECH THERAPY
Entity type:Organization
Organization Name:SUNNY SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAHNIK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:157-829-0148
Mailing Address - Street 1:721 MILDENHALL DR
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-8203
Mailing Address - Country:US
Mailing Address - Phone:715-829-0148
Mailing Address - Fax:
Practice Address - Street 1:1250 FEMRITE DR STE 103
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-3757
Practice Address - Country:US
Practice Address - Phone:608-313-5332
Practice Address - Fax:833-463-2126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty