Doctor Name: | LARA-JILL JENNINGS |
NPI Number: | 1174771497 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SLP |
License Number: | 7088571-4102 |
Business Practice Address: | 6933 S 1300 W West Jordan, UT - 840842554 |
Business Phone Number: | 8014327903 |
Business Fax Number: | |
Mailing Address: | 497 S 1680 E, SPRINGVILLE |
State: | UT |
Postal Code: | 846632727 |
Phone Number: | 8017875900 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2008 |
NPI Last Update Date: | 08/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 7088571-4102 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
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 |