Individual
SALLY JO RADKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
5678 GARLAND LN, GREENDALE, WI 53129-1507
(414) 427-0562
Mailing address
5678GARLANDLN, GREENDALE, WI 53129
(414) 427-0562
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1519154
WI
Other
Enumeration date
05/23/2008
Last updated
05/23/2008
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