Jenny Lee Jerabek, MS CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Eagle River, WI
NPI 1972792471 · NPPES record last updated Oct 20, 2020
Key facts
- NPI
- 1972792471
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2898-154 (WI)
- Practice address
- 201 Hospital Rd
Eagle River, WI 54521-8835 - Phone
- (715) 479-7411
- NPI assigned
- Oct 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2898-154 | WI | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2898-154 | WI | Yes |
Addresses
Primary practice location
201 Hospital Rd
Eagle River, WI 54521-8835
Mailing address
201 Hospital Rd
Eagle River, WI 54521-8835
Phone (715) 479-7411
Other names
- Jenny Lee Primakow/Gaxiola
Other providers in Eagle River, WI
- Hearing Advantage LLC
- Kate Allison Herzog
- Jacleen Hess
- Amber L Heuss
- David Inserra
- Kristie Rose Johns
- Mary J Kahl
- Michelle V Kasmarek
- Deborah Ann Kitch
- Kurt William Klemm
All providers in Eagle River, WI · Speech-Language Pathologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.