Organization
MEQUON SPEECH AND LEARNING CONNECTION
Active
Other names
Milwaukee Myo
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HERKLOTZ MA CCC-SLP, COM (OWNER)
(262) 302-4166
Entity
Organization
Contact information
Practice address
1025 W GLEN OAKS LN STE 107, MEQUON, WI 53092-3372
(262) 302-4166
Mailing address
1025 W GLEN OAKS LN STE 107, MEQUON, WI 53092-3372
(262) 302-4166
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487843074
NPI
—
01
—
1497112122
NPI
—
Enumeration date
02/27/2018
Last updated
08/07/2019
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