Individual
SAMANTHA JEAN WALCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFY-SLP
Contact information
Practice address
5404 W LOOMIS RD, GREENDALE, WI 53129-1411
(414) 421-0088
Mailing address
13455 W FOUNTAIN DR APT 106, NEW BERLIN, WI 53151-3996
(847) 774-3391
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4479-154
WI
Other
Enumeration date
07/04/2017
Last updated
07/04/2017
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