Individual
CAROL LYNN WANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4600 W LOOMIS RD STE 201, GREENFIELD, WI 53220-4858
(414) 281-4466
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
432154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100075408
—
WI
Enumeration date
09/14/2015
Last updated
03/04/2024
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