Provider Demographics
NPI:1326214750
Name:JASKOLSKI, JAYNE ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:JAYNE
Middle Name:ELIZABETH
Last Name:JASKOLSKI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4751 W WOODLAWN CT
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-3656
Mailing Address - Country:US
Mailing Address - Phone:414-475-9055
Mailing Address - Fax:
Practice Address - Street 1:4751 W WOODLAWN CT
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-3656
Practice Address - Country:US
Practice Address - Phone:414-475-9055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI713154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist