Individual
JENNINE LOUISE BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2995 SUB ZERO PKWY, FITCHBURG, WI 53719-8801
(608) 819-6394
Mailing address
2602 WENTWORTH DR, MADISON, WI 53719-3403
(219) 477-7898
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
6058154
WI
235Z00000X
Speech-Language Pathologist
Primary
6366-154
WI
Other
Enumeration date
08/15/2022
Last updated
12/10/2024
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