Provider Demographics
NPI:1851559074
Name:SCHULTZ, JENNIFER LOUISE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LOUISE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43740 US HIGHWAY 18
Mailing Address - Street 2:
Mailing Address - City:FREEMAN
Mailing Address - State:SD
Mailing Address - Zip Code:57029-7301
Mailing Address - Country:US
Mailing Address - Phone:605-387-5768
Mailing Address - Fax:605-387-5768
Practice Address - Street 1:43740 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:FREEMAN
Practice Address - State:SD
Practice Address - Zip Code:57029-7301
Practice Address - Country:US
Practice Address - Phone:605-387-5768
Practice Address - Fax:605-387-5768
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist