| Mikaila Fager, MS, SLP-CCC | |
|
Cerebral Palsy, Inc, 2801 S Webster Ave, Green Bay, WI 54301 | |
| (920) 337-1122 | |
| (920) 337-1121 |
| Full Name | Mikaila Fager |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | Cerebral Palsy, Inc, Green Bay, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083289110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | (Wisconsin) | Secondary |
| 235Z00000X | Speech-language Pathologist | 5262-154 (Wisconsin) | Primary |
| Provider Name | Cerebral Palsy, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1548216484 PECOS PAC ID: 0547327496 Enrollment ID: O20180207001810 |
| Mailing Address | Practice Location Address |
|---|---|
| Mikaila Fager, MS, SLP-CCC Cerebral Palsy, Inc, 2801 S Webster Ave, Green Bay, WI 54301 Ph: (920) 337-1121 | Mikaila Fager, MS, SLP-CCC Cerebral Palsy, Inc, 2801 S Webster Ave, Green Bay, WI 54301 Ph: (920) 337-1122 |
Abigail Sarah Mcclellan, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1114 Chicago St, Green Bay, WI 54301 Phone: 208-380-0163 | |
Abigail Dobbins, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1160 Kepler Dr, Green Bay, WI 54311 Phone: 920-288-4700 | |
Tessa Lynn Heckel, M.S. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 744 S Webster Ave, Green Bay, WI 54301 Phone: 920-433-7822 Fax: 920-733-3651 | |
Rosemary Stine, MS.CCC.SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1525 Creekside Ln, Green Bay, WI 54311 Phone: 920-469-1043 | |
Karly Honken, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: Greenfield Rehab Green Bay, 225 S Monroe Ave #201, Green Bay, WI 53045 Phone: 262-295-6289 | |
Lisa Ann Olson, MS CCC-SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 2801 S Webster Ave, Green Bay, WI 54301 Phone: 920-337-1122 Fax: 920-337-1126 | |
Tanya Ann Vincent, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2801 S Webster Ave, Green Bay, WI 54301 Phone: 920-337-1122 |