Provider Demographics
NPI:1932800034
Name:HOFMEISTER, MADISON (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:HOFMEISTER
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 MARKET ST APT 122
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-4778
Mailing Address - Country:US
Mailing Address - Phone:262-758-4059
Mailing Address - Fax:
Practice Address - Street 1:8440 MARKET ST APT 122
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-4778
Practice Address - Country:US
Practice Address - Phone:262-758-4059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI863090235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist