Provider Demographics
NPI:1548901143
Name:MUNNEKE, JORDYN MARIE (CFY-SLP)
Entity type:Individual
Prefix:
First Name:JORDYN
Middle Name:MARIE
Last Name:MUNNEKE
Suffix:
Gender:F
Credentials:CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022-5010
Mailing Address - Country:US
Mailing Address - Phone:715-425-3911
Mailing Address - Fax:
Practice Address - Street 1:650 BIRCH ST
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:WI
Practice Address - Zip Code:54002-9348
Practice Address - Country:US
Practice Address - Phone:715-684-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist