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Individual

JILL NEGRETE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2395 250TH AVE., CUSHING, WI 54006-1234
(715) 648-5040
Mailing address
2395 250TH AVE., CUSHING, WI 54006-1234

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3401-154
WI
235Z00000X
Speech-Language Pathologist
8324
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1144488669
WI
Enumeration date
05/30/2008
Last updated
03/28/2013
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