Individual
JENNIFER SOWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.T.
Contact information
Practice address
5815 46TH AVE, KENOSHA, WI 53144-2417
(262) 287-8688
(855) 747-1699
Mailing address
5815 46TH AVE, KENOSHA, WI 53144-2417
(262) 287-8688
(855) 747-1699
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/31/2012
Last updated
11/16/2013
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