Doctor Name: | JILL M BOOTH |
NPI Number: | 1144251190 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 665 |
Business Practice Address: | 1702 University Dr S Fargo, ND - 581034940 |
Business Phone Number: | 7013643300 |
Business Fax Number: | 7013648906 |
Mailing Address: | Po Box 6001, FARGO |
State: | ND |
Postal Code: | 581086001 |
Phone Number: | 7013643300 |
Fax Number: | 7013648906 |
NPI Enumeration Date: | 07/06/2006 |
NPI Last Update Date: | 02/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 665 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ND |
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 |