Basic Information
| Provider Information | |||||||||
| NPI: | 1588735153 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STILL | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | MHS, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7904 FLAGSTAFF ST | ||||||||
| Address2: | |||||||||
| City: | COMMERCE TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483822327 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 475 MARKET PL | ||||||||
| Address2: | BUILDING 1, SUITE 100 | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481081649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349988119 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2006 | ||||||||
| LastUpdateDate: | 10/02/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.