Provider Demographics
NPI:1558874453
Name:MINGS, JASON ANDREW
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ANDREW
Last Name:MINGS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 GRANGE HALL RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-8997
Mailing Address - Country:US
Mailing Address - Phone:618-889-3427
Mailing Address - Fax:
Practice Address - Street 1:2233 GRANGE HALL RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-8997
Practice Address - Country:US
Practice Address - Phone:618-889-3427
Practice Address - Fax:618-889-3427
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist