Doctor Name: | MRS. JESSICA JAN SHONES |
NPI Number: | 1710121421 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 7591 |
Business Practice Address: | 68541 275th Ave Lake City, MN - 550414856 |
Business Phone Number: | 6517641315 |
Business Fax Number: | 6512670023 |
Mailing Address: | 68541 275th Ave, LAKE CITY |
State: | MN |
Postal Code: | 550414856 |
Phone Number: | 6517641315 |
Fax Number: | 6512670023 |
NPI Enumeration Date: | 04/24/2009 |
NPI Last Update Date: | 04/24/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 7591 |
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 |