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General NPI Number Information
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NPI Number | 1689283608
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Entity Type | Individual
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Provider Name | JAMIE LYNN GAWLE M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/26/2020
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Last Update Date | 09/10/2023
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Provider Practice Location Address
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Address Line | 1000 N 92ND ST
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City | MILWAUKEE
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State | WI
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Zip | 53226-3533
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Country | US
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Telephone | 414-479-9460
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 CLEVELAND AVE
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City | LA GRANGE PARK
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State | IL
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Zip | 60526-1305
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Country | US
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Telephone | 708-227-7741
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146.014772
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 6340-154
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License Number State | WI
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