JACQUELYN WAGNER

MILWAUKEE, WI
NPI1134290935
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: WI  2978154)
Additional Taxonomies235Z00000X Speech-Language Pathologist,
(Licence: IL  242.000217)
Enumeration Date2006-11-13
Last Update Date2008-09-18
Business Address
-- JACQUELYN WAGNER MS CCC-SLP
833 N 26TH ST
MILWAUKEE, WI 53233-1507
Phone number: 414-344-7676
Mailing Address
-- JACQUELYN WAGNER MS CCC-SLP
833 N 26TH STREET
MILWAUKEE, WI 53233-4345
Phone number: 414-344-7676