Individual
JENNIFER BOLLWAHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 222-1734
Mailing address
414 GOWER BAE, WALES, WI 53183-9603
(262) 422-1837
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3750-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20182700
—
WI
01
—
525586
MEDICARE NUMBER
WI
Enumeration date
10/11/2012
Last updated
10/30/2025
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