Provider Demographics
NPI:1184890865
Name:REKOSKE, LYNN (MS CCC SLP)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:REKOSKE
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W153N10356 ROGERS DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-5221
Mailing Address - Country:US
Mailing Address - Phone:262-253-1211
Mailing Address - Fax:
Practice Address - Street 1:W153N10356 ROGERS DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022-5221
Practice Address - Country:US
Practice Address - Phone:262-253-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI958-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42648600Medicaid