Provider Demographics
NPI:1659989507
Name:VANDEN LANGENBERG, CASSANDRA CLAIRE (MS CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:CLAIRE
Last Name:VANDEN LANGENBERG
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MS
Other - First Name:CASSANDRA
Other - Middle Name:CLAIRE
Other - Last Name:PETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:W3048 KRUEGER RD
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:WI
Mailing Address - Zip Code:54165-8232
Mailing Address - Country:US
Mailing Address - Phone:920-419-6559
Mailing Address - Fax:
Practice Address - Street 1:2725 S MOORLAND RD
Practice Address - Street 2:SUITE 301
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151
Practice Address - Country:US
Practice Address - Phone:414-329-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5030-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist