Provider Demographics
NPI:1851459739
Name:MCGINN, JILL MARIE (SLP)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:MARIE
Last Name:MCGINN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HALSTEAD
Mailing Address - State:KS
Mailing Address - Zip Code:67056-2202
Mailing Address - Country:US
Mailing Address - Phone:316-830-3653
Mailing Address - Fax:
Practice Address - Street 1:712 N MONROE AVE
Practice Address - Street 2:
Practice Address - City:SEDGWICK
Practice Address - State:KS
Practice Address - Zip Code:67135-9492
Practice Address - Country:US
Practice Address - Phone:316-772-5185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS248235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist