Individual
JILLIAN BETH WALCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2725 S MOORLAND RD STE 301, NEW BERLIN, WI 53151-3720
(414) 329-2500
Mailing address
530 CECELIA ST, COMBINED LOCKS, WI 54113-1408
(616) 401-6511
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6464-154
WI
Other
Enumeration date
02/19/2018
Last updated
02/06/2024
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