Provider Demographics
NPI:1255100103
Name:SCHILLINGER, JENNIFER (MS, EMBA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SCHILLINGER
Suffix:
Gender:F
Credentials:MS, EMBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4955 17TH AVE S STE 122
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-3372
Mailing Address - Country:US
Mailing Address - Phone:701-532-1353
Mailing Address - Fax:701-532-1505
Practice Address - Street 1:4955 17TH AVE S STE 122
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-3372
Practice Address - Country:US
Practice Address - Phone:701-532-1353
Practice Address - Fax:701-532-1505
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2023-12-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health