Jennifer June Lang, M.S.

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

NPI 1992094551 · NPPES record last updated Dec 20, 2017

Key facts

NPI
1992094551
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
146.006405 (IL)
Practice address
625 E. Monroe St
Cuba, IL 61427
Phone
(309) 785-5012
NPI assigned
Apr 5, 2011
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)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146.006405ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146.006405 IL Yes

Addresses

Primary practice location

625 E. Monroe St
Cuba, IL 61427

Mailing address

314 Peoria St
Lincoln, IL 62656-1653
Phone (309) 678-2666

Other providers in Cuba, IL

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

Sources for this page

Verify at the official NPI Registry.