Provider Demographics
NPI:1295763936
Name:LEDTKE, MONARA BETH (AUD)
Entity type:Individual
Prefix:DR
First Name:MONARA
Middle Name:BETH
Last Name:LEDTKE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 COMMERCIAL CT
Mailing Address - Street 2:SUITE #102
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-4564
Mailing Address - Country:US
Mailing Address - Phone:262-249-8585
Mailing Address - Fax:262-249-8587
Practice Address - Street 1:875 TOWNLINE RD UNIT 101
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-5517
Practice Address - Country:US
Practice Address - Phone:262-249-5855
Practice Address - Fax:262-249-8589
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI458-156231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist