Martin, Jennifer Farragut

Martin, Jennifer Farragut is an sole proprietor health care provider with primary practice located at 137 Beechwood Dr , Hattiesburg MS 39402-1442. 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. Martin, Jennifer Farragut can be contacted via phone (601) 466-0876.

Contact Information

Primary practice address
137 Beechwood Dr Hattiesburg MS 39402-1442
Phone: (601) 466-0876
Fax: (601) 579-0283
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X S2463 Mississippi

Profile Details

NPI number 1063554657
LBN Legal business name Martin, Jennifer Farragut
Credentials MSCCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 12th, 2007
Last updated May 25th, 2011 - about 15 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 1063554657 NPPES
Mississippi MEDICAID 00429208

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