Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Sandra Renee Moog, MS/CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1467625269

Mrs. Sandra Renee Moog, MS/CCC-SLP is a Qualified Speech Language Pathologist in Milwaukee, Wisconsin. Qualified in 2004, 22 years ago. Practices with Reliant Senior Living LLC, a 108-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
22
Licensed in
WI
In the registry since
2008
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Practice location Address checks out

3540 S 43rd St
Milwaukee, WI 53220-1502
Phone: (414) 328-2104
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 2681-154 (WI)

Record details

NPI number1467625269
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS/CCC-SLP
Sole proprietorYes
NPI enumeratedApril 12, 2008
Last updated in NPPESApril 12, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Reliant Senior Living Llc — 108 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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