| Doctor Name: | JENNIFER HATHORN |
| NPI Number: | 1144655127 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CCC-SLP |
| License Number: | 3121 |
| Business Practice Address: | 6800 Nw 39th Expy Bethany, OK - 730082513 |
| Business Phone Number: | 4054409866 |
| Business Fax Number: | 4057820024 |
| Mailing Address: | 6800 Nw 39th Expy, BETHANY |
| State: | OK |
| Postal Code: | 730082513 |
| Phone Number: | 4054409866 |
| Fax Number: | 4057820024 |
| NPI Enumeration Date: | 09/09/2013 |
| NPI Last Update Date: | 10/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 3121 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| 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 |