Healthcare Provider Details

I. General information

NPI: 1447413349
Provider Name (Legal Business Name): JESSICA MARIE MORELLO SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 MILES ST
CHIPPEWA FALLS WI
54729-1923
US

IV. Provider business mailing address

16200 COUNTY HIGHWAY G
STANLEY WI
54768-5507
US

V. Phone/Fax

Practice location:
  • Phone: 715-726-2412
  • Fax:
Mailing address:
  • Phone: 715-429-0033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1590056904
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: