Individual
JILLIAN UTZ LEBAKKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
MS
Contact information
Practice address
1201 NEWPORT LN, HOLMEN, WI 54636-8635
(608) 526-1600
Mailing address
1201 NEWPORT LN, HOLMEN, WI 54636-8635
(608) 526-1600
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
832420
WI
Other
Enumeration date
12/22/2025
Last updated
12/22/2025
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