Provider Demographics
NPI:1740248871
Name:SCHOENHAAR, KIMBERLY JO (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:JO
Last Name:SCHOENHAAR
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:JO
Other - Last Name:MILAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1 RANCH HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53716-2471
Mailing Address - Country:US
Mailing Address - Phone:608-222-3274
Mailing Address - Fax:
Practice Address - Street 1:1 RANCH HOUSE LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53716-2471
Practice Address - Country:US
Practice Address - Phone:608-222-3274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2020-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist