1871414722 NPI number — GABRIELLE PAIGE SIUDZINSKI APSW

Table of content: GABRIELLE PAIGE SIUDZINSKI APSW (NPI 1871414722)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871414722 NPI number — GABRIELLE PAIGE SIUDZINSKI APSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIUDZINSKI
Provider First Name:
GABRIELLE
Provider Middle Name:
PAIGE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871414722
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/24/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1142 ORLANDO DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOBART
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54115-9484
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-351-8772
Provider Business Mailing Address Fax Number:
920-278-5367

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1142 ORLANDO DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOBART
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54115-9484
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-351-8772
Provider Business Practice Location Address Fax Number:
920-278-5367
Provider Enumeration Date:
07/24/2026

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  136217-121 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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