Bennett, Jason D

Bennett, Jason D is an individual health care provider with primary practice located at 2131 S Business Dr , Sheboygan WI 53081-5656. 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. Bennett, Jason D can be contacted via phone (920) 803-1617.

Contact Information

Primary practice address
2131 S Business Dr Sheboygan WI 53081-5656
Phone: (920) 803-1617
Fax: (920) 803-1622
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 2963-154 Wisconsin

Profile Details

NPI number 1336320258
LBN Legal business name Bennett, Jason D
Credentials MS-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 19th, 2007
Last updated Dec 12th, 2011 - about 14 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 1336320258 NPPES
Wisconsin MEDICAID 41813000

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