Jill M Hagan
Individual provider Active NPI Speech-Language Pathologist · Malta Bend, MO
NPI 1376684050 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1376684050
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 200 South Linn
Malta Bend, MO 65339-0010 - Phone
- (660) 595-2371
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Saline Malta Bend R-V School | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
200 South Linn
Malta Bend, MO 65339-0010
Mailing address
PO Box 10
Malta Bend, MO 65339-0010
Other providers in Malta Bend, MO
- County of Saline Malta Bend R-V School
- Missouri Valley Respiratory Pharmacy LLC
- Susan Todd
- Kathy L Wilson
All providers in Malta Bend, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.