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NPI Code Detail

MEDICARE: JULIA WILDENBERG MS, CCC-SLP

MEDICARE: JULIA WILDENBERG MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist6031-154WI

General Provider Information

NPI Number : 1821716507
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA WILDENBERG MS, CCC-SLP
Provider Business Mailing Address
First Line : 2801 S WEBSTER AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-2894
Country : US
Telephone Number : 920-337-1122
Fax Number : 920-337-1126
Provider Business Practice Location Address
First Line : 2801 S WEBSTER AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-2894
Country : US
Telephone Number : 920-337-1122
Fax Number : 920-337-1126
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2022
Last Update Date : 08/07/2024

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Directions to “ JULIA WILDENBERG MS, CCC-SLP” Practice Location

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