Doctor Name: | MRS. JENNIFER LEE GIBBS |
NPI Number: | 1053645390 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | SP9232 |
Business Practice Address: | 3637 Medina Rd Suite 220 Medina, OH - 442569654 |
Business Phone Number: | 3309520403 |
Business Fax Number: | 3309520826 |
Mailing Address: | 150 N Miller Rd, Bldg. 150a FAIRLAWN |
State: | OH |
Postal Code: | 443333770 |
Phone Number: | 3308672240 |
Fax Number: | 3308672245 |
NPI Enumeration Date: | 09/18/2009 |
NPI Last Update Date: | 09/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP9232 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
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 |