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Individual

JENNY STAVAST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1021 W NATIONAL AVE, MILWAUKEE, WI 53204-1347
(515) 450-0700
Mailing address
8336 AVON CT, WAUWATOSA, WI 53213-3304
(262) 993-3297

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
04/24/2025
Last updated
04/24/2025
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