Jill R. Andrus, M.S. CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Logan, UT

NPI 1497198592 · NPPES record last updated Apr 9, 2013

Key facts

NPI
1497198592
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
6652668-4102 (UT)
Practice address
1000 Old Main HL
Logan, UT 84322-1000
Phone
(435) 797-8799
Fax
(435) 797-0221
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6652668-4102UTMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6652668-4102 UT Yes

Addresses

Primary practice location

1000 Old Main HL
Logan, UT 84322-1000

Mailing address

970 E 80 N
Smithfield, UT 84335-2538
Phone (435) 797-8799

Other providers in Logan, UT

All providers in Logan, UT · Speech-Language Pathologist in Utah

Sources for this page

Verify at the official NPI Registry.