Booth, Jill M

Booth, Jill M is an individual health care provider with primary practice located at 1702 University Dr S , Fargo ND 58103-4940. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Booth, Jill M can be contacted via phone (701) 364-3300.

Contact Information

Primary practice address
1702 University Dr S Fargo ND 58103-4940
Phone: (701) 364-3300
Fax: (701) 364-8906
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 665 North Dakota
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP8027 Arizona
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 1311 North Dakota

Profile Details

NPI number 1144251190
LBN Legal business name Booth, Jill M
Credentials SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Feb 7th, 2014 - about 12 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 1144251190 NPPES
North Dakota MEDICAID 52524
North Dakota Other 43G40BO
North Dakota Other 20605
North Dakota Other ND200229
North Dakota Other SLP8027
North Dakota Other 4600456
North Dakota Other 1782578
North Dakota Other 4600421

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