Doctor Name: | MISS JENNIFER LYNN BOOTH |
NPI Number: | 1215271416 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CFY-SLP |
License Number: | TSLP5742 |
Business Practice Address: | 1111 N Mission Park Blvd #1088 Chandler, AZ - 852243988 |
Business Phone Number: | 8157620723 |
Business Fax Number: | 4808990330 |
Mailing Address: | 1111 N Mission Park Blvd, #1088 CHANDLER |
State: | AZ |
Postal Code: | 852243988 |
Phone Number: | 8157620723 |
Fax Number: | 4808990330 |
NPI Enumeration Date: | 11/12/2012 |
NPI Last Update Date: | 11/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | TSLP5742 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
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 |