Individual
JORDAN CARLY JANE BECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC/SLP
Contact information
Practice address
1354 N 65TH ST, WAUWATOSA, WI 53213-2972
(414) 208-0753
Mailing address
1354 N 65TH ST, WAUWATOSA, WI 53213-2972
(414) 208-0753
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3132-154
WI
Other
Enumeration date
01/19/2010
Last updated
08/26/2012
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