| Doctor Name: | JENNIFER JOYCE STREET |
| NPI Number: | 1326339714 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.ED |
| License Number: | |
| Business Practice Address: | 30 Buxton Farm Rd Stamford, CT - 069051224 |
| Business Phone Number: | 2036748200 |
| Business Fax Number: | |
| Mailing Address: | 30 Buxton Farm Rd, STAMFORD |
| State: | CT |
| Postal Code: | 069051224 |
| Phone Number: | 2036748200 |
| Fax Number: | |
| NPI Enumeration Date: | 04/20/2011 |
| NPI Last Update Date: | 10/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 02/14/2013 |
| NPI Reactivation Date: | 03/18/2014 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |