Provider Demographics
NPI:1447532429
Name:VERBRIGGHE, JEANNE C (SLP)
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:C
Last Name:VERBRIGGHE
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:E1998
Mailing Address - Street 2:STATEROAD M-94
Mailing Address - City:EBEN JCT.
Mailing Address - State:MI
Mailing Address - Zip Code:49825
Mailing Address - Country:US
Mailing Address - Phone:906-439-5704
Mailing Address - Fax:906-439-5704
Practice Address - Street 1:E1998
Practice Address - Street 2:STATE ROAD M-94
Practice Address - City:RUMELY
Practice Address - State:MI
Practice Address - Zip Code:49825
Practice Address - Country:US
Practice Address - Phone:906-439-5704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist