Doctor Name: | MRS. JENNIFER ANN LOGAN MAIDEN |
NPI Number: | 1003091273 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED CCC-SLP |
License Number: | 22002881A |
Business Practice Address: | 5170 Gateway Ave Noblesville, IN - 460626772 |
Business Phone Number: | 3174324247 |
Business Fax Number: | 3178776618 |
Mailing Address: | 5170 Gateway Ave, NOBLESVILLE |
State: | IN |
Postal Code: | 460626772 |
Phone Number: | 3174324247 |
Fax Number: | 3178776618 |
NPI Enumeration Date: | 01/07/2008 |
NPI Last Update Date: | 01/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22002881A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |