Individual
TARA JEAN JUNGERBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CFY-SLP
Contact information
Practice address
14 ELLIS POTTER CT, MADISON, WI 53711-2478
(608) 204-6242
(608) 204-6249
Mailing address
14 ELLIS POTTER CT, MADISON, WI 53711-2478
(608) 204-6242
(608) 204-6249
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2862-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42580500
—
WI
Enumeration date
11/01/2006
Last updated
07/09/2007
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