MEDICARE: JENNA HORLACHER

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	1294	ND

General Provider Information

NPI Number	:	1295169365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA HORLACHER

Provider Business Mailing Address
First Line	:	500 UNIVERSITY AVE W
Second Line	:
City	:	MINOT
State	:	ND
Zip	:	58707-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 UNIVERSITY AVE W
Second Line	:
City	:	MINOT
State	:	ND
Zip	:	58707-0001
Country	:	US
Telephone Number	:	701-858-3595
Fax Number	:

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

Provider Enumeration Date	:	08/26/2013
Last Update Date	:	08/26/2013

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Directions to “ JENNA HORLACHER ” Practice Location

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