Provider Demographics
NPI:1528234960
Name:RASMUSSON, CYNTHIA C
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:C
Last Name:RASMUSSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23539 NEON LN
Mailing Address - Street 2:
Mailing Address - City:RICHLAND CENTER
Mailing Address - State:WI
Mailing Address - Zip Code:53581-6391
Mailing Address - Country:US
Mailing Address - Phone:608-647-6000
Mailing Address - Fax:608-647-4134
Practice Address - Street 1:23539 NEON LN
Practice Address - Street 2:
Practice Address - City:RICHLAND CENTER
Practice Address - State:WI
Practice Address - Zip Code:53581-6391
Practice Address - Country:US
Practice Address - Phone:608-647-6000
Practice Address - Fax:608-647-4134
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI273154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42718500Medicaid