Individual
JORDAN RAE ILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
520 N 28TH AVE, WAUSAU, WI 54401-4101
(715) 845-4900
Mailing address
2428 FROSTY PINES LN, KRONENWETTER, WI 54455-9276
(608) 558-9246
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5261-154
WI
Other
Enumeration date
06/16/2021
Last updated
03/08/2023
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