Individual
JOELLE WILDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1053 LOVERS LN, BOWLING GREEN, KY 42103-7166
(270) 807-0335
Mailing address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
(502) 233-9074
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
284669
KY
235Z00000X
Speech-Language Pathologist
46003338A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200196020A
—
IN
Enumeration date
12/31/2015
Last updated
05/11/2023
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