MEDICARE: JILLIAN A HOWE MS CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2202005368	VA

General Provider Information

NPI Number	:	1083891493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILLIAN A HOWE MS CCC-SLP

Provider Business Mailing Address
First Line	:	622 WINDWARD DR
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-3196
Country	:	US
Telephone Number	:	585-317-6566
Fax Number	:

Provider Business Practice Location Address
First Line	:	845 FIRST COLONIAL RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6160
Country	:	US
Telephone Number	:	757-321-9292
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2008
Last Update Date	:	02/17/2012

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