Provider Demographics
NPI:1730223991
Name:NAEGER, JILL SUZANNE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:SUZANNE
Last Name:NAEGER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21894 STATE ROUTE B
Mailing Address - Street 2:
Mailing Address - City:SAINTE GENEVIEVE
Mailing Address - State:MO
Mailing Address - Zip Code:63670-9179
Mailing Address - Country:US
Mailing Address - Phone:573-756-9807
Mailing Address - Fax:
Practice Address - Street 1:21894 STATE ROUTE B
Practice Address - Street 2:
Practice Address - City:SAINTE GENEVIEVE
Practice Address - State:MO
Practice Address - Zip Code:63670-9179
Practice Address - Country:US
Practice Address - Phone:573-756-9807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000167452235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist