Doctor Name: | JENNIFER MARIE MASKULINSKI |
NPI Number: | 1023275450 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC-SLP |
License Number: | 22004233A |
Business Practice Address: | 801 E Lasalle Ave South Bend, IN - 466172814 |
Business Phone Number: | 5742377845 |
Business Fax Number: | 5744726294 |
Mailing Address: | 801 E Lasalle Ave, SOUTH BEND |
State: | IN |
Postal Code: | 466172814 |
Phone Number: | 5742377845 |
Fax Number: | 5744726294 |
NPI Enumeration Date: | 05/22/2008 |
NPI Last Update Date: | 05/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22004233A |
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 |