Provider Demographics
NPI:1144774746
Name:WEBER, JOZETTE LORRAINE (SLP)
Entity Type:Individual
Prefix:
First Name:JOZETTE
Middle Name:LORRAINE
Last Name:WEBER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JOZETTE
Other - Middle Name:LORRAINE
Other - Last Name:KITZROW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3656 MALL DR
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-7634
Mailing Address - Country:US
Mailing Address - Phone:715-858-2100
Mailing Address - Fax:715-552-4567
Practice Address - Street 1:3656 MALL DR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-7634
Practice Address - Country:US
Practice Address - Phone:715-858-2100
Practice Address - Fax:715-552-4567
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4284-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist