Doctor Name: | MR. JEROME MARCOUILLER QUELLIER |
NPI Number: | 1033242128 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CCC-SLP |
License Number: | 6362 |
Business Practice Address: | 640 Jackson St Mail Stop 11102d Regions Hospital Saint Paul, MN - 55101 |
Business Phone Number: | 6512549281 |
Business Fax Number: | |
Mailing Address: | 640 Jackson Street, Mail Stop 11102d Regions Hospital SAINT PAUL |
State: | MN |
Postal Code: | 55101 |
Phone Number: | 6512549281 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2007 |
NPI Last Update Date: | 05/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 6362 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |