Healthcare Provider Details

I. General information

NPI: 1225957921
Provider Name (Legal Business Name): JENNY HAVLOVICK PHD, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 4TH AVE RM 39
STEVENS POINT WI
54481-1909
US

IV. Provider business mailing address

1901 4TH AVE RM 39
STEVENS POINT WI
54481-1909
US

V. Phone/Fax

Practice location:
  • Phone: 715-346-3667
  • Fax: 715-346-2157
Mailing address:
  • Phone: 715-346-3667
  • Fax: 715-346-2157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7496-154
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: