MRS. SANDRA RENEE MOOG MS/CCC-SLP NPI 1467625269

NPI Information

  • NPI: 1467625269
  • Provider Name: MRS. SANDRA RENEE MOOG, MS/CCC-SLP
  • Classification: Speech-Language Pathologist - 235Z00000X
  • Entity Type: Individual
  • Address: 3540 S 43RD ST
    MILWAUKEE, WI
    ZIP 53220
  • Phone: (414) 328-2104

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NPI Details

MRS. Sandra Renee Moog, MS/CCC-SLP is a speech language pathologist in Milwaukee, WI. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. MRS. Sandra Renee Moog, MS/CCC-SLP NPI is 1467625269. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3540 S 43RD ST
MILWAUKEE, WI
ZIP 53220-502
Phone: (414) 328-2104

The enumeration date for this NPI number is 4/12/2008 and was last updated on 4/12/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1235Z00000XSpeech-Language Pathologist2681-154WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
142586400MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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