Thea Sue Cornwell, CFY-SLP | |
1836 South Ave, La Crosse, WI 54601-5429 | |
(608) 782-7300 | |
Not Available |
Full Name | Thea Sue Cornwell |
---|---|
Gender | Female |
Speciality | Speech-language Pathologist |
Location | 1836 South Ave, La Crosse, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508599358 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 528308 (Minnesota) | Secondary |
235Z00000X | Speech-language Pathologist | 6199 (Wisconsin) | Primary |
Provider Name | Mayo Clinic |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1922074434 PECOS PAC ID: 6507778255 Enrollment ID: O20031103000285 |
Mailing Address | Practice Location Address |
---|---|
Thea Sue Cornwell, CFY-SLP 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 | Thea Sue Cornwell, CFY-SLP 1836 South Ave, La Crosse, WI 54601-5429 Ph: (608) 782-7300 |
Aimee A Balistreri, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Stacey L. Burds, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 700 West Ave S, La Crosse, WI 54601 Phone: 608-785-0940 | |
Cynthia G Meisner, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Ana Carolina Thormann, SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Sarah E Graboski, MS CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1900 South Ave, La Crosse, WI 54601 Phone: 920-412-8047 | |
Taryn Jean Simon, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 | |
Julie C Wise, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1836 South Ave, La Crosse, WI 54601 Phone: 608-782-7300 |