Georgenson, Jodi A
Georgenson, Jodi A is an individual health care provider with primary practice located at 5908 Gordon Rd , Sturgeon Bay WI 54235-3131. 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. Georgenson, Jodi A can be contacted via phone (920) 746-7756.Contact Information
Primary practice address
5908 Gordon Rd
Sturgeon Bay WI 54235-3131
Phone: (920) 746-7756
Fax: (920) 592-9320
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 2150-154 | Wisconsin |
Profile Details
| NPI number | 1740341650 |
|---|---|
| LBN Legal business name | Georgenson, Jodi A |
| Credentials | MS CCC SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 13th, 2006 |
| Last updated | Apr 2nd, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740341650 | NPPES |
| Wisconsin | MEDICAID | 42788100 |
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