Ambort, Casey Jo

Ambort, Casey Jo is an individual health care provider with primary practice located at 626 East Slifer St , Portage WI 53901. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Ambort, Casey Jo can be contacted via phone (608) 742-8814.

Contact Information

Primary practice address
626 East Slifer St Portage WI 53901
Phone: (608) 742-8814
Fax: (608) 742-2384
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X Wisconsin

Profile Details

NPI number 1639328867
LBN Legal business name Ambort, Casey Jo
Credentials M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2008
Last updated Jul 9th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639328867 NPPES
Wisconsin MEDICAID 42579800

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