Provider Demographics
NPI:1447489588
Name:HESSELBERG, BARBARA ANN (MS/CCC-SLP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:HESSELBERG
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 W JAMES ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:WI
Mailing Address - Zip Code:53925-1372
Mailing Address - Country:US
Mailing Address - Phone:920-318-9139
Mailing Address - Fax:
Practice Address - Street 1:449 W JAMES ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:WI
Practice Address - Zip Code:53925-1372
Practice Address - Country:US
Practice Address - Phone:920-318-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI802-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist