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Individual

JACQUELINE LEITSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
N2325 ELM ST, WAUTOMA, WI 54982-8093
(949) 813-8216
Mailing address
N2325 ELM ST, WAUTOMA, WI 54982-8093
(949) 813-8216

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6810154
WI

Other

Enumeration date
01/13/2025
Last updated
01/13/2025
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