Individual
JENNA MARIE MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
1125 N 13TH ST, SHEBOYGAN, WI 53081-3281
(920) 803-1617
Mailing address
1125 N 13TH ST, SHEBOYGAN, WI 53081-3281
(920) 803-1617
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6629-154
WI
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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