Avery, Jack D.

Avery, Jack D. is an individual health care provider with primary practice located at Minneapolis Vamc 1 Veterans Drive, Minneapolis MN 55417. He recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as his primary health care specialty. Avery, Jack D. can be contacted via phone (612) 467-5289.

Contact Information

Primary practice address
Minneapolis Vamc 1 Veterans Drive Minneapolis MN 55417
Phone: (612) 467-5289
Fax: (612) 467-2144
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 5938 Minnesota

Profile Details

NPI number 1306930086
LBN Legal business name Avery, Jack D.
Credentials CCC/SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306930086 NPPES
Minnesota Other 5938 SPEECH PATHOLOGY LICENSE
Minnesota Other 01103833 SPEECH PATHOLOGY LICENSE

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