Provider Demographics
NPI:1356022164
Name:THEMIDWESTSLP LLC
Entity type:Organization
Organization Name:THEMIDWESTSLP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:DEPAUW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-212-5814
Mailing Address - Street 1:1123 BRIARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-2069
Mailing Address - Country:US
Mailing Address - Phone:517-212-5814
Mailing Address - Fax:
Practice Address - Street 1:1123 BRIARWOOD CT
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-2069
Practice Address - Country:US
Practice Address - Phone:517-212-5814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech