Jessica Lynn Engledow, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Marshall, IL

NPI 1104036276 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104036276
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
314 S 5TH St
Marshall, IL 62441-1403
Phone
(217) 826-5278
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
146.008452ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X IL Yes

Addresses

Primary practice location

314 S 5TH St
Marshall, IL 62441-1403

Mailing address

314 S 5TH St
Marshall, IL 62441-1403
Phone (217) 826-5278

Other providers in Marshall, IL

All providers in Marshall, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.