Phillips, Jennifer Rae

Phillips, Jennifer Rae is an sole proprietor health care provider with primary practice located at 774 Fairmount Ave , Jamestown NY 14701-2609. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Agencies / Case Management. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Phillips, Jennifer Rae can be contacted via phone (716) 338-0668.

Contact Information

Primary practice address
774 Fairmount Ave Jamestown NY 14701-2609
Phone: (716) 338-0668
Fax: (866) 694-4979
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 02324358 New York
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 013565-1 New York
Agencies / Case Management 251B00000X

Profile Details

NPI number 1477567675
LBN Legal business name Phillips, Jennifer Rae
Credentials MS, CCC-SLP/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2006
Last updated Jan 26th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477567675 NPPES
New York MEDICAID 02324358

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