| Doctor Name: | MRS. KIMBERLY DAWN JASENSKY |
| NPI Number: | 1114068400 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS CCC SLP |
| License Number: | SA6765 |
| Business Practice Address: | 7749 Normandy Blvd 147 Jacksonville, FL - 322210756 |
| Business Phone Number: | 9047865576 |
| Business Fax Number: | 9047869907 |
| Mailing Address: | 3599 University Blvd South, JACKSONVILLE |
| State: | FL |
| Postal Code: | 322164252 |
| Phone Number: | 9048912736 |
| Fax Number: | |
| NPI Enumeration Date: | 02/09/2007 |
| NPI Last Update Date: | 11/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA6765 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |