Provider Demographics
NPI:1053437467
Name:KASAT, EMMIE JO (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMMIE
Middle Name:JO
Last Name:KASAT
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 1:4605 VALDRES SPRINGS COURT
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WI
Mailing Address - Zip Code:54476
Mailing Address - Country:US
Mailing Address - Phone:715-393-0400
Mailing Address - Fax:715-393-0435
Practice Address - Street 1:4605 VALDRES SPRINGS COURT
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476
Practice Address - Country:US
Practice Address - Phone:715-393-0400
Practice Address - Fax:715-393-0435
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2611-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42566800Medicaid