Individual
MRS. JACQUELINE JAN THINGVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
E7404A COUNTY BB, VIROQUA, WI 54665-1139
(608) 637-5400
Mailing address
3149 26TH ST S, LA CROSSE, WI 54601-7654
(608) 787-5576
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1091-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1091-154
WISCONSIN SPEECH PATHOLOGIST LICENSE
WI
Enumeration date
05/15/2008
Last updated
05/15/2008
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