Individual
JACLYN MENZEL BORCHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1834 W WISCONSIN AVE, LOWER LEVEL, MILWAUKEE, WI 53233-2125
(414) 933-9813
(414) 933-1522
Mailing address
1834 W WISCONSIN AVE, LOWER LEVEL, MILWAUKEE, WI 53233-2125
(414) 933-9813
(414) 933-1522
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2849154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42582500
—
WI
Enumeration date
05/03/2007
Last updated
11/02/2009
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